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Combination of HIV/malaria increases complications during pregnancy

Netherlands Organization for Scientific Research

Women with a combined HIV/malaria infection more frequently experience complications during pregnancy than healthy women. This is revealed in research from Kenya. However, to their surprise the researchers established that HIV-infected mothers with a mild malaria infection less frequently transmit the HIV infection to their children than HIV-infected mothers without malaria.

In Kenya, the epidemiologists Annemieke van Eijk and John Ayisi investigated the interaction between HIV and malaria as well as the effect of both infections on mother and child during and after the pregnancy. The research revealed that pregnant women have a greater chance of developing malaria. This chance is even greater if the woman is pregnant for the first time. Also women younger than 20 years and women with an HIV infection are more susceptible to malaria.

Women with the combination HIV/malaria turned out to have a greater chance of developing anaemia during pregnancy and after childbirth. Their children also developed anaemia more often. If the child has HIV, the chance of it developing anaemia is greater. If the child has both HIV and malaria, anaemia develops even more frequently.

Surprisingly it turned out that HIV-infected mothers with malaria transmitted the HIV infection to their children less frequently than mothers without malaria. However, in such cases the mother must have a mild malaria infection and not a severe form. Unfortunately it is still not possible to accurately predict whether a mild malaria infection will remain mild or develop into the severe form.

The researchers argue that many complications can be prevented in Kenya, as the majority of pregnant women attend at least one pregnancy check-up. During the check-up the midwife could take action, for example, by prescribing malaria medication or providing advice about special mosquito nets. If HIV is detected during the check-up, the physician or midwife can provide special medicines for this.

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Further information can be obtained from Dr Annemieke van Eijk and Dr John Ayisi (Kenya Medical Research Institute, Centre of Disease Control), tel. 254-35-22-983 and 254-35-22-929, fax 254-35-22-981, e-mail avaneijk@kisian.mimcom.net and jayisi@kisian.mimcom.net. The doctoral thesis was defended on 15 October 2002. Dr Van Eijk's and Dr Ayisi's supervisor was Prof. P.A. Kager (University of Amsterdam and the Academic Medical Centre, University of Amsterdam).

On 16 October 2002 a symposium entitled 'Malaria and HIV infection in pregnancy' was held at the University of Amsterdam Medical Centre in response to the doctoral research of John Ayisi and Annemieke van Eijk. Further information about this symposium can be obtained from Eva Hartkamp (secretariat Infectious Diseases, Tropical medicine and Aids), tel. 31-205-664-380, e-mail e.l.hartkamp@amc.uva.nl. A copy of the thesis can also be obtained from Eva Hartkamp.

The research was funded by the Netherlands organisation for Scientific Research (NWO).

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