Can Malaria Interfere with the Diagnosis of HIV Infection?

A 40 year old woman presented to the medical outpatient clinic of University of Nigeria Teaching Hospital Enugu with an acute febrile illness. She had blood film malaria parasitaemia of 2,400 parasites/μl, and tested positive to human immunodeficiency virus (HIV) 1 & 11 using rapid test kit. She was counseled and offered HIV confirmatory test which turned out indeterminate. She was treated for malaria using artemisinin-based combination therapy and advised to come back after three months for repeat HIV test. Three months later, the patient now asymptomatic with negative malaria parasite film was re-screened for HIV using enzyme linked immunosorbent assay (ELISA) technique which turned out negative. Our findings suggest that malaria may interfere with diagnosis of HIV infection especially when using the rapid test kit and hence give wrong epidemiological data – this also has grave implications for the individual patient. This observation is important in populations where both malaria and HIV are endemic.