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Background <p>Although interactions between human immunodeficiency virus <b>(</b>HIV) and <i>Plasmodium falciparum</i> infections may lead to an exponential rise in their harmful impact on human health, few data exist on the prevalence of <i>Plamodium</i> species, the multiplicity of infection and molecular markers of antimalarial drug resistance, as well as clinical presentation of malaria infections in Congolese people living with HIV (PLWH). The aim of this study was to characterize malaria infection among PLWH receiving antiretroviral treatment (ART) and co-trimoxazole prophylaxis in Brazzaville, Republic of Congo.</p> Method <p>As part of follow-up activities, blood samples, socio-demographic and clinical data were collected from 683 PLWH aged from 1 month to 84 years (sex ratio male/female of 0.4) under ART and co-trimoxazole prophylaxis. This heath facility-based cross-sectional study was conducted from January to September 2022 at the Outpatient Treatment Center of the National HIV Program, located in Brazzaville. Malaria infection was diagnosed by microscopy and nested PCR. Single nucleotide polymorphisms (SNP) were detected by RFLP-PCR for the <i>Pfdhfr</i>, <i>Pfdhps</i>, <i>Pfcrt</i> genes and by sequencing for the <i>PfK13</i> and <i>Pfmdr1</i> genes. <i>Plasmodium falciparum</i> genetic diversity was investigated by nested PCR using gene markers (<i>msp1</i>, <i>msp2</i> and <i>glurp</i>).</p> Results <p>All the <i>Plasmodium</i> infected participants were asymptomatic. By microscopy, 1.2% (8/683) were found to be infected, whereas 9.2% (62/675) carried submicroscopic infections detected by PCR. <i>P. falciparum</i> mono-infection was the most common (69/70, 98.6%), but single separate cases of <i>P. malariae</i> alone, and of co-infection, <i>P. falciparum</i> with <i>P. ovale</i>, were also detected. The mean multiplicity of <i>P. falciparum</i> infection was 2.1 ± 1.09, with 68.1% of infections being polyclonal. Overall, a high prevalence of mutations was found within the <i>Pfdhfr</i> gene: 51<b>I</b> (78.2%), 59<b>R</b> (84.2%), 108<b>N</b> (84.0%); <i>Pfdhps</i> gene: 437<b>G</b> (72.0%, 540<b>E</b> (30.8%), 581<b>G</b> (48.5%); <i>Pfcrt</i> gene: 76<b>T</b> (46.9%) and <i>Pfmdr1</i>gene: 184<b>F</b> (42.1%). None of the <i>Pfmdr1</i> 86<b>Y</b>, 1034<b>C</b>, 1042<b>D</b>, and 1246<b>Y</b> mutant alleles or of the 12 significant mutations known to confer artemisinin partial resistance, were detected.</p> Conclusion <p>The results of this study show a very low prevalence of malaria infection and a comparatively low genetic diversity of <i>P. falciparum</i> in isolates from PLWH under antiretroviral therapy and co-trimoxazole-based chemoprophylaxis in Brazzaville.</p>

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Characterization of Plasmodium falciparum infections among people living with HIV under antiretroviral and co-trimoxazole chemoprophylaxis in Brazzaville, Republic of Congo

  • 期刊论文

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  • 发表日期：

    2025年12月24日

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  • Jean Claude Djontu,
  • Marcel Tapsou Baina,
  • Jacques Dollon Mbama Ntabi,
  • Claujens Chastel Mfoutou Mapanguy,
  • Armel Landry Batchi-Bouyou,
  • Viny Andzi Elenga,
  • Franck Yannis Kouikani,
  • Arcel Christ Massamba Ndala,
  • Alain Maxime Mouanga,
  • Francine Ntoumi

摘要

Background

Although interactions between human immunodeficiency virus (HIV) and Plasmodium falciparum infections may lead to an exponential rise in their harmful impact on human health, few data exist on the prevalence of Plamodium species, the multiplicity of infection and molecular markers of antimalarial drug resistance, as well as clinical presentation of malaria infections in Congolese people living with HIV (PLWH). The aim of this study was to characterize malaria infection among PLWH receiving antiretroviral treatment (ART) and co-trimoxazole prophylaxis in Brazzaville, Republic of Congo.

Method

As part of follow-up activities, blood samples, socio-demographic and clinical data were collected from 683 PLWH aged from 1 month to 84 years (sex ratio male/female of 0.4) under ART and co-trimoxazole prophylaxis. This heath facility-based cross-sectional study was conducted from January to September 2022 at the Outpatient Treatment Center of the National HIV Program, located in Brazzaville. Malaria infection was diagnosed by microscopy and nested PCR. Single nucleotide polymorphisms (SNP) were detected by RFLP-PCR for the Pfdhfr, Pfdhps, Pfcrt genes and by sequencing for the PfK13 and Pfmdr1 genes. Plasmodium falciparum genetic diversity was investigated by nested PCR using gene markers (msp1, msp2 and glurp).

Results

All the Plasmodium infected participants were asymptomatic. By microscopy, 1.2% (8/683) were found to be infected, whereas 9.2% (62/675) carried submicroscopic infections detected by PCR. P. falciparum mono-infection was the most common (69/70, 98.6%), but single separate cases of P. malariae alone, and of co-infection, P. falciparum with P. ovale, were also detected. The mean multiplicity of P. falciparum infection was 2.1 ± 1.09, with 68.1% of infections being polyclonal. Overall, a high prevalence of mutations was found within the Pfdhfr gene: 51I (78.2%), 59R (84.2%), 108N (84.0%); Pfdhps gene: 437G (72.0%, 540E (30.8%), 581G (48.5%); Pfcrt gene: 76T (46.9%) and Pfmdr1gene: 184F (42.1%). None of the Pfmdr1 86Y, 1034C, 1042D, and 1246Y mutant alleles or of the 12 significant mutations known to confer artemisinin partial resistance, were detected.

Conclusion

The results of this study show a very low prevalence of malaria infection and a comparatively low genetic diversity of P. falciparum in isolates from PLWH under antiretroviral therapy and co-trimoxazole-based chemoprophylaxis in Brazzaville.