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Immunohematological profiles and viral load among HIV patients with and without malaria coinfection in Northwest Ethiopia
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DOI：10.1186/s12879-026-14223-4.png)
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Abstract
En 中文
Malaria and Human Immunodeficiency Virus (HIV) remain major public health challenges in sub-Saharan Africa, including Ethiopia. Their coexistence leads to complex interactions that may worsen hematological abnormalities and immune suppression. However, comparative data on hematological profiles among malaria–HIV coinfected and HIV mono-infected individuals are limited in the study area. The objective of this study is to assess the immunohematological Parameters and Viral Load among HIV Patients with and without malaria attending an antiretroviral therapy clinic at selected health facilities in NorthWest, Ethiopia. A health institution-based comparative cross-sectional study was conducted from May to November 2022 among adult HIV-infected patients attending the ART clinic at selected health facilities in North Western, Ethiopia. After obtaining consent forms, participants were recruited using a consecutive sampling technique, and data were collected by face-to-face interview. Blood samples were collected for malaria parasite detection, hematological profile, viral load, and CD4 + T cell count. Data was entered using Epi Info 7 and analyzed using SPSS Version 25. An independent sample t- test was used to compare the mean difference of hematological profile, CD4+ T cell count, viral load, HIV/malaria coinfection, and HIV without malaria infection. Binary and multivariable logistic regression analyses were used to determine the association between selected independent variables and abnormal hematological profile. Multivariable linear regression analysis was used to assess the independent association between malaria-HIV coinfection and log₁₀ viral load. p-value < 0.05 was considered a level of significance. The study found significant differences in hematological parameters between the two groups. The mean white blood cell count, red blood cell count, hemoglobin level, and platelet count were significantly lower among malaria–HIV coinfected participants compared to HIV mono-infected individuals (p < 0.05). The prevalence of anemia was significantly higher in the coinfected group (58.7%) compared to the HIV-mono infected group (30.7%) (p = 0.001). Similarly, leukopenia (33.3% vs. 12%) and thrombocytopenia (40% vs. 16%) were more common among coinfected participants (p < 0.05). Participants with malaria HIV coinfection had a significantly higher mean log10 viral load than those with HIV mono-infection (p = 0.001). Although the mean CD4 + T cell count was lower in coinfected individuals, the difference was not statistically significant. Malaria HIV co-infection was independently associated with increased odds of anemia (AOR = 3.79, 95% CI: 1.80–7.90, p = 0.001), leukopenia (AOR = 4.10, 95% CI: 1.67–10.23, p = 0.002), and thrombocytopenia (AOR = 4.45, 95% CI: 1.80–10.90, p = 0.001), as well as higher log10 viral load levels(B = 0.378, 95% CI: 0.205–0.552,p = 0.001). Malaria HIV coinfection had lower WBC, RBC, hemoglobin, and platelet counts and a higher prevalence of anemia, leukopenia, and thrombocytopenia as compared to HIV monoinfection individuals. Furthermore, coinfected people also exhibited higher viral loads. These findings highlight the need for integrated screening, early diagnosis, and routine hematological monitoring in coinfected patients to improve clinical outcomes. Not applicable (NA).
Keywords:
HIV
Malaria
Hematological profile
Co-infection
Ethiopia
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