Prolonged elevation of viral loads in HIV-1-infected children in a region of intense malaria transmission in Northern Uganda

increased viral load by 0.42 log (95% CI 0.29-0.78, p = 0.0002), higher than that reported in adults. These patients’ viral loads returned to levels similar to those at baseline after treatment. In 13 patients with high parasitaemia (10-20/HPF), the mean increase in viral load was 0.53 log (0.14 to 0.51), p < 0.0001, remaining significantly higher than at baseline after treatment ie. mean difference (signed-rank test) in viral load “before” and “after” malaria was significant. Discussion P. falciparum malaria increased HIV-1 viral loads in children, with some viral loads remaining elevated several weeks after antimalarial treatment. Prolonged posttreatment elevation has important implications for the clinical course and the potential for transmission in sexually active adults.