HIV &Treatment Bill Brieger | 04 Apr 2007 06:49 pm
Did Malaria Drugs ‘Cause’ HIV?
George Parris wrote recently in Medical Hypotheses about the likelihood that a malaria medicine trial of pamaquine/plasmoquine in Leopoldville (Kinshasha) in 1927 basically interfered with the work of an existing retrovirus that may have actually helped primate T-cells attack the liver stage of the malaria parasite, and hypothesized that later use of chloroquine exacerbated the problem. Please read the article for the technical details. Based on this analysis, he discounts the common zoonotic hypotheses of the origins of HIV.
If this hypothesis proves true, it is only fitting that the Global Fund addresses both HIV and Malaria, but should do so in equal measure now that new non-chloroquine antimalarial drugs are being promoted. In addition many studies exsit to show the negative synergies between HIV and Malaria. Laufer and Plowe suggest that the effect of malaria infection on HIV disease progression due to increased viral replication may be important and needs to be fully explored. Desai et al. report that HIV increases the risk of malaria and its adverse effects in pregnant women. In a review of recent research Slutsker and Marston state that HIV-infected persons are at increased risk for clinical malaria; the risk is greatest when immune suppression is advanced. They also note that adults with advanced HIV may be at risk for failure of malaria treatment, especially with sulfa-based therapies, and that malaria is associated with increases in HIV viral load that, while modest, may impact HIV progression or the risk of HIV transmission.
Clearly we cannot undo the past, but it is incumbent on countries where both HIV and Malaria coexist to plan integrated and conprehensive approaches to managing both diseases