- The Washington Times - Thursday, December 7, 2006

Malaria is fueling the spread of AIDS in Africa by boosting the virus in victim’s bodies for weeks at a time, making it easier to pass on, says a study that pins down the deadly interplay between the dual scourges.

It’s a vicious cycle as people weakened by HIV are more vulnerable to malaria.

University of Washington researchers who estimated the impact of the overlapping infections concluded that the interaction could be blamed for thousands of HIV infections and almost a million bouts of malaria over two decades in just one part of Kenya.

The research, published in today’s edition of the journal Science, highlights the need for a joint attack on both epidemics.

“It’s an important paper,” said Dr. Anthony Fauci of the National Institutes of Health, the government’s leading infectious disease specialist. “We really need to be much more serious about what we do about malaria at the same time we’re serious about what we do about HIV.”

Anti-malaria programs, such as a $1.2 billion U.S. initiative in its early stages, “assume a much, much greater imperative when you realize not only are you going to have an impact on one disease, but you might impact another disease,” Dr. Fauci said.

Malaria sickens up to half a billion people annually and kills more than one million, mostly young children and mostly in Africa — which also bears the biggest HIV burden. Sub-Saharan Africa is home to 24.7 million HIV-infected people; about two million died this year, according to the U.N.

Scientists long have suspected the two diseases fuel each other. The new study created a mathematical model to figure out just how much they do.

HIV is most easily spread when patients have high virus levels in their blood. A bout of malaria causes a temporary surge — a stunning sevenfold increase — in those levels, said lead researcher Laith Abu-Raddad, a scientist at the University of Washington.

The surge may last six weeks to eight weeks, far longer than it takes a typical adult to recover from malaria and begin sexual activity again. Adults in intense malaria areas get the parasitic disease once or twice a year.

Moreover, HIV patients are more susceptible to malaria reinfection because of their weakened immune systems.

Armed with that information, Mr. Abu-Raddad turned to Kisumu, Kenya, a region where he found good data tracking HIV and malaria prevalence over decades, and even information on sexual behavior such as average number of partners and volume of sex workers.

In regions where both diseases are common, malaria may be responsible for almost 5 percent of HIV infections, and HIV may be behind 10 percent of malaria episodes. In Kisumu, that translated into 8,500 extra HIV infections and 980,000 extra malaria bouts over two decades, he concluded.

“It’s a substantial impact,” Mr. Abu-Raddad said, adding that it helps to explain HIV’s explosive spread across southern Africa.

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