Triple infection with HIV, TB and malaria

Summary: Given that malaria, TB and HIV are the world’s three most serious and common infections prevalent in low income countries, this study was designed to evaluate the impact of these diseases occurring as triple, double and single infections on haemoglobin levels, malaria parasitaemia, acid fast bacilli (AFB) and CD4+ cell counts. Design: This was a 6-months hospital-based laboratory survey conducted on 400 consented participants between March and September 2009. Setting: The study was conducted in the Limbe Regional Hospital which is the main reference centre for HIV, TB and malaria for the South West Region. Results: The mean haemoglobin concentration of those with mono-infection of TB (13.4 ± 2.6 g/dl), malaria (11.4 ± 2.3 g/dl) and HIV (12.0 ± 2.4g/dl) were higher when compared with those of co-infections with malaria/ HIV (11.0 ± 2.7 g/dl), TB/malaria (10.4 ± 2.6 g/dl), HIV/TB (10.8 ± 2.2 g/dl) and HIV/TB/malaria triple infection (10.1 ± 2.0 g/dl). Mean parasite density in malaria mono-infection was 410.0 ± 2515.5 parasites/µl, that of TB/malaria co-infection was 271.0 ± 198.7 parasites/µl, HIV/malaria co-infection was 366.5 ± 215.6 parasites/µl and HIV/TB/malaria triple infection was 461.1 ± 295.0 parasites/µl when CD4+ cell count was considered, those with triple infection had a mean CD4+ cell count of 193.3 ± 200.3 cells/µl, those with co-infections of HIV/malaria and HIV/TB co-infections had CD4+ cell count of 176.2 ± 154.1 cells/µl and 112.7 ± 76.7 cells/µl respectively while patients with HIV mono infection had a mean CD4+ cell count of 187.39 ± 167.71 cells/µl. We recorded the highest mean AFB count in patients with triple infection (21.3 ± 15.9 AFB/ field), followed by those co-infected with TB/malaria (18.0 ± 11.8 AFB/Field) and those with mono-infection of TB (15.0 ± 13.3 3 AFB/Field). Those with HIV/TB co-infection recorded the least number of AFB count (12.1 ± 14.1 AFB/Field). Conclusion: We therefore concluded that triple infection with TB, HIV and malaria leads to an increase in malaria parasitaemia, AFB count and decreased Hgb levels with no impact on the progressive depletion of CD4+ cells in HIV infection