Research

Improving HIV/AIDS Care by Detecting and Treating Malaria in HIV Co-Infected Individuals in Southern India

Agency: REACH

Award: 20081006

Overlapping geographic distributions have brought malaria and HIV together in many regions of the world. When the two infections occur in the same individual, their interactions adversely affect the outcomes of both diseases. Malarial episodes, for instance, hasten HIV disease progression and HIV+ patients are more likely to contract malaria. This knowledge regarding malaria and HIV co-infection comes from microscopy-based studies conducted in sub-Saharan Africa where Plasmodium falciparum is endemic. We cannot extrapolate these findings directly to our study population in southern India. In our proposed cohort, there is predominantly unstable malaria transmission with P. vivax. Recent preliminary studies from India have demonstrated a prevalence of neuropsychological impairment (NPI) in HIV+ individuals and other studies have shown NPI in individuals with malaria in the absence of the severe clinical syndrome of "cerebral malaria". Even though these dangerous pathogens can infect the same host, their combined effects on the brain are virtually uninvestigated. The overall goals of this project will be 1) to identify malaria co-infection and confirm treatment success using a highly sensitive assay, and 2) to demonstrate the effects of previously undetected malaria on HIV disease progression and neuropsychological (NP) performance in HIV+ individuals in southern India. The findings of this study will 1) lead to improvement in HIV/AIDS care of our study population through screening and treatment of asymptomatic malaria, 2) make it possible to apply for NIH and other funding to expand the program, and 3) stimulate research to determine the mechanism behind NPI in co-infected people.