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Severe malaria is a major cause of childhood mortality in sub-Saharan Africa but the factors predisposing children to severe forms of malaria have not been fully elucidated. In a case-control study of over 1,200 Gambian children hepatitis B virus carriage was significantly increased amongst cases of severe malaria compared to matched controls. We suggest that this association may relate to impaired clearance of liver stage parasites in the presence of the reduced level of HLA class I antigen expression on hepatocytes infected by hepatitis B virus. If this association is causal and viral carriage predisposes to severe malaria, widespread vaccination against hepatitis B virus may reduce mortality from severe malaria.

Original publication

DOI

10.1038/nm0495-374

Type

Journal article

Journal

Nature medicine

Publication Date

04/1995

Volume

1

Pages

374 - 375

Addresses

Hepatology Unit, St. Mary's Hospital Medical School, Imperial College of Science, Technology and Medicine, London, UK.

Keywords

Liver, Animals, Humans, Plasmodium falciparum, Hepatitis B virus, Hepatitis B, Malaria, Cerebral, Malaria, Falciparum, Hepatitis B Surface Antigens, Enzyme-Linked Immunosorbent Assay, Prevalence, Odds Ratio, Case-Control Studies, Carrier State, Child, Child, Preschool, Gambia