Maputo — Researchers from Mahidol University in Bangkok, working on data from the central Mozambican city of Beira, have shown that people infected with the HIV virus that causes AIDS are more likely to suffer from complications and die as a result of malaria.

It has been commonly accepted that malarial deaths often go hand in hand with HIV. However, the researchers point out that whilst co-infection is common in settings with a high prevalence of both diseases, “there is little information on whether HIV affects the clinical presentation and outcome of severe malaria”.

Writing in the academic journal “Clinical Infectious Diseases”, the authors state that “HIV transmission and progression may be accelerated by malaria.

Conversely, HIV infection increases the incidence of clinical malaria, severe malaria, and malaria-related mortality, particularly in adults with deteriorating immune status”.

The study was based on patients with severe malaria admitted to Beria Central Hospital. The central province of Sofala is an area with a high prevalence of HIV infection as well as malaria.

In the study of patients hospitalised by malaria, for children younger than 15 the rate of HIV infection was eleven per cent while for adults the rate was 72 per cent.

The researchers found that children with HIV and malaria had more severe acidosis, anaemia and respiratory problems, and the malaria was more severe. In addition, these children were found to be more likely to go into a coma, suffer from convulsions, and catch pneumonia. The mortality rate was 26 per cent compared with 9 per cent for children with malaria but without HIV.

According to the authors, “this is the first prospective study to report the different clinical presentations of severe malaria, parasite burden, and mortality in HIV co-infected patients. It was shown that HIV co-infected children with severe malaria were more undernourished and presented more frequently with severe acidosis, severe anaemia, respiratory distress, and elevated blood urea nitrogen concentrations, and similar (albeit non-significant) trends were found in HIV-infected adults”.

The researchers conclude that “early identification of HIV co-infection is important for the clinical management of severe malaria”.

Despite huge strides in fighting malaria, Mozambique still has about three million cases each year (down from about six million in 2005).

The study was funded by the British charitable foundation the Wellcome Trust.