Should we care about Plasmodium vivax and HIV co-infection? A systematic review and a cases series from the Brazilian Amazon

Del-Tejo, Paola López; Cubas-Vega, Nadia; Caraballo-Guerra, Cecilia; Silva, Bernardo Maia da; Valente, Jefferson da Silva; Sampaio, Vanderson Souza; Baía-da-Silva, Djane Clarys; Castro, Daniel Barros de; Martínez-Espinosa, Flor Ernestina; Siqueira, André Machado; Lacerda, Marcus Vinícius Guimarães; Monteiro, Wuelton Marcelo; Val, Fernando

doi:10.1186/s12936-020-03518-9

Cited by 8 publications

(7 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the Amazon rain forest both malaria and EBV infections are common, yet Burkitt's lymphoma (BL) is rare [48]; this is not unexpected as endemic BL (eBL) is linked to P. falciparum exposure, but not to other malaria parasites [20]. While P. vivax malaria is a public health problem in the Amazon, immunological outcomes of prevalent viral co-infections are often neglected [49][50][51]. Here, we sought to investigate whether a continuous detection of EBV-DNA in peripheral blood of P. vivax malaria-exposed adults (PersV DNA ) could impact antibody response to key P. vivax blood-stage vaccine candidates.…”

Section: Discussionmentioning

confidence: 99%

Impact of Epstein-Barr virus co-infection on natural acquired Plasmodium vivax antibody response

Dias

Guimarães

Barcelos

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: The simultaneous infection of Plasmodium falciparum and Epstein-Barr virus (EBV) could promote the development of the aggressive endemic Burkitt's Lymphoma (eBL) in children living in P. falciparum holoendemic areas. While it is well-established that eBL is not related to other human malaria parasites, the impact of EBV infection on the generation of human malaria immunity remains largely unexplored. Considering that this highly prevalent herpesvirus establishes a lifelong persistent infection on B-cells with possible influence on malaria immunity, we hypothesized that EBV co-infection could have impact on the naturally acquired antibody responses to P. vivax, the most widespread human malaria parasite. Methodology/Principal Findings: The study design involved three cross-sectional surveys at six-month intervals (baseline, 6 and 12 months) among long-term P. vivax exposed adults living in the Amazon rainforest. The approach focused on a group of malaria-exposed individuals whose EBV-DNA (amplification of balf-5 gene) was persistently detected in the peripheral blood (PersV DNA, n=27), and an age-matched malaria-exposed group whose EBV-DNA could never be detected during the follow-up (NegV DNA, n=29). During the follow-up period, the serological detection of EBV antibodies to lytic/latent viral antigens showed that IgG antibodies to viral capsid antigen (VCA-p18) were significantly different between groups (PersV DNA > NegV DNA ). A panel of blood-stage P. vivax antigens covering a wide range of immunogenicity confirmed that in general PersV DNA group showed low levels of antibodies as compared with NegV DNA. Interestingly, more significant differences were observed to a novel DBPII immunogen, named DEKnull-2, which has been associated with long-term neutralizing antibody response. Differences between groups were less pronounced with blood-stage antigens (such as MSP1-19) whose levels can fluctuate according to malaria transmission. Conclusions/Significance: In a proof-of-concept study we provide evidence that a persistent detection of EBV DNA in peripheral blood of adults in a P. vivax semi-immune population may impact the long-term immune response to major malaria vaccine candidates.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of Epstein-Barr virus co-infection on natural acquired Plasmodium vivax antibody response

Dias

Guimarães

Barcelos

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…While P . vivax malaria is a public health problem in the Amazon, immunological outcomes of prevalent viral co-infections are often neglected [ 55 – 57 ]. Here, we sought to investigate whether a continuous detection of EBV-DNA in peripheral blood of P .…”

Section: Discussionmentioning

confidence: 99%

Impact of Epstein-Barr virus co-infection on natural acquired Plasmodium vivax antibody response

et al. 2022

View full text Add to dashboard Cite

Background The simultaneous infection of Plasmodium falciparum and Epstein-Barr virus (EBV) could promote the development of the aggressive endemic Burkitt’s Lymphoma (eBL) in children living in P. falciparum holoendemic areas. While it is well-established that eBL is not related to other human malaria parasites, the impact of EBV infection on the generation of human malaria immunity remains largely unexplored. Considering that this highly prevalent herpesvirus establishes a lifelong persistent infection on B-cells with possible influence on malaria immunity, we hypothesized that EBV co-infection could have impact on the naturally acquired antibody responses to P. vivax, the most widespread human malaria parasite. Methodology/Principal findings The study design involved three cross-sectional surveys at six-month intervals (baseline, 6 and 12 months) among long-term P. vivax exposed individuals living in the Amazon rainforest. The approach focused on a group of malaria-exposed individuals whose EBV-DNA (amplification of balf-5 gene) was persistently detected in the peripheral blood (PersVDNA, n = 27), and an age-matched malaria-exposed group whose EBV-DNA could never be detected during the follow-up (NegVDNA, n = 29). During the follow-up period, the serological detection of EBV antibodies to lytic/ latent viral antigens showed that IgG antibodies to viral capsid antigen (VCA-p18) were significantly different between groups (PersVDNA > NegVDNA). A panel of blood-stage P. vivax antigens covering a wide range of immunogenicity confirmed that in general PersVDNA group showed low levels of antibodies as compared with NegVDNA. Interestingly, more significant differences were observed to a novel DBPII immunogen, named DEKnull-2, which has been associated with long-term neutralizing antibody response. Differences between groups were less pronounced with blood-stage antigens (such as MSP1-19) whose levels can fluctuate according to malaria transmission. Conclusions/Significance In a proof-of-concept study we provide evidence that a persistent detection of EBV-DNA in peripheral blood of adults in a P. vivax semi-immune population may impact the long-term immune response to major malaria vaccine candidates.

show abstract

“…vivax . There is no strong evidence for an interaction between vivax malaria and HIV, although few studies have looked at coinfection [ 9 ].…”

Section: Clinical Features Of Vivax Malariamentioning

confidence: 99%

Clinical impact of vivax malaria: A collection review

et al. 2022

View full text Add to dashboard Cite

Background Plasmodium vivax infects an estimated 7 million people every year. Previously, vivax malaria was perceived as a benign condition, particularly when compared to falciparum malaria. Reports of the severe clinical impacts of vivax malaria have been increasing over the last decade. Methods and findings We describe the main clinical impacts of vivax malaria, incorporating a rapid systematic review of severe disease with meta-analysis of data from studies with clearly defined denominators, stratified by hospitalization status. Severe anemia is a serious consequence of relapsing infections in children in endemic areas, in whom vivax malaria causes increased morbidity and mortality and impaired school performance. P. vivax infection in pregnancy is associated with maternal anemia, prematurity, fetal loss, and low birth weight. More than 11,658 patients with severe vivax malaria have been reported since 1929, with 15,954 manifestations of severe malaria, of which only 7,157 (45%) conformed to the World Health Organization (WHO) diagnostic criteria. Out of 423 articles, 311 (74%) were published since 2010. In a random-effects meta-analysis of 85 studies, 68 of which were in hospitalized patients with vivax malaria, we estimated the proportion of patients with WHO-defined severe disease as 0.7% [95% confidence interval (CI) 0.19% to 2.57%] in all patients with vivax malaria and 7.11% [95% CI 4.30% to 11.55%] in hospitalized patients. We estimated the mortality from vivax malaria as 0.01% [95% CI 0.00% to 0.07%] in all patients and 0.56% [95% CI 0.35% to 0.92%] in hospital settings. WHO-defined cerebral, respiratory, and renal severe complications were generally estimated to occur in fewer than 0.5% patients in all included studies. Limitations of this review include the observational nature and small size of most of the studies of severe vivax malaria, high heterogeneity of included studies which were predominantly in hospitalized patients (who were therefore more likely to be severely unwell), and high risk of bias including small study effects. Conclusions Young children and pregnant women are particularly vulnerable to adverse clinical impacts of vivax malaria, and preventing infections and relapse in this groups is a priority. Substantial evidence of severe presentations of vivax malaria has accrued over the last 10 years, but reporting is inconsistent. There are major knowledge gaps, for example, limited understanding of the underlying pathophysiology and the reason for the heterogenous geographical distribution of reported complications. An adapted case definition of severe vivax malaria would facilitate surveillance and future research to better understand this condition.

show abstract

Should we care about Plasmodium vivax and HIV co-infection? A systematic review and a cases series from the Brazilian Amazon

Cited by 8 publications

References 64 publications

Impact of Epstein-Barr virus co-infection on natural acquired Plasmodium vivax antibody response

Impact of Epstein-Barr virus co-infection on natural acquired Plasmodium vivax antibody response

Impact of Epstein-Barr virus co-infection on natural acquired Plasmodium vivax antibody response

Clinical impact of vivax malaria: A collection review

Contact Info

Product

Resources

About