Malarija u osoba zaraženih HIV-om

master's thesis

• Title (english): Malaria in HIV-infected persons
• Author: Kristina Friščić
• Mentor: Josip Begovac (mentor)
• Committee member: Davorka Lukas (predsjednik povjerenstva)
• Committee member: Goran Tešović (član povjerenstva)
• Committee member: Josip Begovac (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Infectious Diseases); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract

Malarija je bolest uzrokovana parazitom Plasmodium spp. koji pripada skupini protozoa. U većini slučajeva prezentira se kao akutna febrilna bolest koja se dijagnosticira gustom kapi i razmazom periferne krvi, a u terapiji se pretežito koriste klorokin i artemizinski derivati. Virus humane imunodeficijencije (HIV) humani je retrovirus roda Lentivirus koji se replicira u CD4+ limfocitima T te njihovim posljedičnim uništenjem dovodi do uznapredovale bolesti. U liječenju se koristi antiretrovirusna terapija koja zaraženim osobama omogućuje normalan životni vijek. Najveća prevalencija koinfekcije vidi se u afričkim državama s najvećom prevalencijom HIV-a koje se ujedno preklapaju s endemičnim područjima za malariju, a to je gotovo cijelo područje supsaharske Afrike. Poznato je da se u slučaju koinfekcije kompleksnim interakcijama pogoršava prognoza i jedne i druge bolesti. U osoba zaraženih HIV-om s niskim brojem CD4+ stanica dolazi do povišenja parazitemije plazmodija, komplicirane malarije i teže anemije te smanjenja djelotvornosti antimalarika. Malarija povećava replikaciju HIV-a u krvi, smanjuje broj CD4+ stanica te ubrzava napredovanje bolesti. Iznimno je važno spriječiti malariju u osoba zaraženih HIV-om, stoga se kao profilaksa koriste sulfadoksin s pirimetaminom (SP) i kotrimoksazol te mreže za spavanje tretirane insekticidima.

Abstract (english)

Malaria is an infectious disease caused by the protozoan parasite Plasmodium spp. It is typically characterized by an acute febrile illness. Malaria can be diagnosed either by thick or thin blood smear and is treated mostly with chloroquine and artemisinin derivatives. Human immunodeficiency virus (HIV) is a retrovirus of the genus Lentivirus that replicates in CD4+ T lymphocytes. Subsequent destruction of T lymphocytes is linked with disease progression. HIV infection is treated with antiretroviral therapy which allows patients to reach a normal life expectancy. The highest prevalence of coinfection can be seen in endemic African countries with the highest HIV prevalence. This includes most of Sub-Saharan Africa. It is widely known that prognosis of both diseases worsens in the case of coinfection considering a broad range of interactions. HIV infected persons with low CD4 count and malaria present with a higher parasitaemia, complicated or severe malaria, and
reduced efficacy of antimalarials. Malaria acts on HIV by raising the viral load, lowering the CD4 count, and accelerating disease progression. It is extremely important to prevent malaria in HIV infected persons. Therefore, sulfadoxine-pyrimethamine (SP) and cotrimoxazole are used in chemoprophylaxis, as well as insecticide treated bed nets, as a mode of primary prevention.

• Keywords: malarija; HIV; koinfekcija; interakcije; prevencija malarije
• Keywords (english): malaria; HIV; coinfection; interactions; malaria prevention
• Language: croatian
• URN:NBN: urn:nbn:hr:105:031535
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-03 10:18:05