Objectives
The aim of the study is to see if HIV influences the severity and outcome of Plasmodium Falciparum Malaria.
Design and methods
This is a retrospective analysis of ICU records of patients admitted to the ICU at the Chris Hani Baragwanath Hospital between 1990 and 1999 with a confirmed diagnosis of malaria. 70 of the 152 patients had their HIV status defined, those were reviewed.
Results
See Tables.
Table 1.
Characteristics
| HIV positive (n = 20) | HIV negative (n = 50) | P value | |||
|---|---|---|---|---|---|
| Male/female ratio | 12 M | 8 F | 26 M | 24 F | 0.454 |
| ICU stay (median/range) | 4.5 days | 1–16 | 5 days | 0.5–37 | > 0.10 |
| Parasitaemia (median/range) | 14.5% | 1–50% | 1% | < 1–71% | > 0.10 |
| WHO criteria (median/range) | 5.5 | 0–11 | 5 | 1–12 | > 0.10 |
| APACHE II (median/range) | 16 | 10–29 | 17.5 | 6–38 | > 0.10 |
| Incidence of ARDS | 3/20 | 15% | 14/50 | 28% | 0.278 |
| Incidence of ARF | 12/20 | 60% | 26/50 | 52% | 0.454 |
| Incidence of ARDS & ARF | 3/20 | 15% | 12/50 | 12% | 0.372 |
Table 2.
Outcome
| HIV positive | HIV negative | P value | |||
|---|---|---|---|---|---|
| Overall mortality | 8/20 | 40% | 15/50 | 30% | 0.375 |
| Mortality of ARDS | 3/3 | 100% | 11/14 | 78% | 0.571 |
| Mortality of ARF | 8/12 | 66% | 13/26 | 50% | 0.410 |
| Mortality of ARDS & ARF | 3/3 | 100% | 10/12 | 83% | 0.600 |
Conclusions
There is no interaction between HIV seropositivity and severe Plasmodium Falciparum Malaria. HIV status does not impact on severity of malaria. The incidence and outcome of Multiple Organ Failure related to Malaria is not significantly different in HIV infected patients.