Asian Journal of Advances in Medical Science

Background: Malaria and Human Immunodeficiency Virus (HIV) infection remain major health challenges in sub-Saharan Africa, where co-infection is common due to geographical overlap. Plasmodium falciparum infection among HIV-infected individuals may increase parasite burden and contribute to haematological abnormalities, particularly anaemia.

Objective: This study assessed the relationship between P. falciparum parasite density, haemoglobin genotype and packed cell volume (PCV) among HIV-infected patients attending the University of Maiduguri Teaching Hospital (UMTH).

Methods: A hospital-based cross-sectional study was conducted among 813 HIV-infected patients attending the PEPFAR clinic at UMTH. Data were collected using structured questionnaires and laboratory investigation forms. Blood samples were analysed for P. falciparum parasitaemia, parasite density, haemoglobin genotype and PCV. Haemoglobin genotype was determined using haemoglobin electrophoresis, while malaria parasitaemia was assessed using standard laboratory methods. Data were analysed using descriptive statistics, chi-square test, analysis of variance, correlation and regression analysis at a 5% level of significance.

Results: The study recorded a P. falciparum parasitaemia prevalence of 15.5% (126/813) among HIV-infected patients. The mean parasite density was 1,248.6 ± 965.4 parasites/μL, while the mean PCV was 33.8 ± 5.7%. Linear regression analysis showed a significant negative relationship between parasite density and PCV (β = -0.006, p < 0.001), indicating that increased parasite density was associated with reduced PCV levels. The distribution of haemoglobin genotypes showed that HbAA was the predominant genotype (69.2%), followed by HbAS (26.3%), HbSS (2.6%) and HbAC (1.9%). Parasite density differed significantly across haemoglobin genotypes (F = 12.67, p < 0.001), with HbAA individuals recording the highest mean parasite density compared with other genotypes. Multiple regression analysis further demonstrated that parasite density was an independent predictor of reduced PCV (β = -0.004, p < 0.001), while haemoglobin genotype contributed significantly to variations in PCV.

Conclusion: P. falciparum parasitaemia remains an important co-infection among HIV-positive patients, and parasite density significantly influences haematological status. Evaluation of malaria infection, parasite density, haemoglobin genotype and PCV should be incorporated into the comprehensive management of HIV-infected individuals in malaria-endemic settings.