Genetic diversity of Plasmodium falciparum in people living with HIV in Ogbomoso, Nigeria: Implications for malaria transmission and treatment.

Introduction: HIV and malaria coexist in individuals across sub-Saharan Africa, a region profoundly impacted by both diseases. Plasmodium falciparum exhibits significant genetic diversity in high-transmission areas, which may further complicate the clinical outcomes of people living with HIV (PLWH). This study investigates the genetic diversity of P. falciparum among PLWH in Ogbomoso, Nigeria.

Materials and methods: A total of 254 blood samples were collected from HIV-positive patients attending clinics at LAUTECH Teaching Hospital and BOWEN Teaching Hospital in Ogbomoso, Oyo State, Nigeria. Malaria infection was diagnosed using a rapid diagnostic test (RDT), microscopy, and nested polymerase chain reaction (nPCR). Genotyping of msp-1, msp-2, and glurp genes was performed to assess genetic diversity. The distribution of allelic families was analysed descriptively using SPSS v.27, and a p-value≤ 0.05 was considered statistically significant.

Results: Among the 254 samples, females (72.8%; mean age 40.7 years) were the most predominant. The prevalence of P. falciparum was 5.9%, 55.1%, and 40.6% by RDT, microscopy, and nPCR, respectively. The msp-1 geno-typing identified 170 distinct variants, with the K1, MAD20, and RO33 families detected at frequencies of 34.7%, 30.0%, and 35.3%, respectively. The msp-2 genotyping revealed 56 alleles, predominantly from the FC27 family (73.2%). The multiplicity of infection (MOI) for msp-1, msp-2, and glurp genes was 2.02, 1.13, and 1.00, respectively, while the expected heterozygosity (H_E) values were 0.86, 0.52, and 0.10, respectively. Most msp-1 (68.5%) and glurp (31.1%) samples exhibited polyclonality, whereas msp-2 samples were predominantly monoclonal (22.1%). .

Conclusions: Despite the high malaria transmission intensity in the region, P. falciparum isolates from PLWH exhibited relatively low genetic diversity, suggesting a potential reduction in malaria transmission and signalling the effectiveness of malaria control strategies. Further studies are needed to explore the underlying factors leading to reduced transmission and low genetic variations in this population and their potential impact on malaria transmission and treatment outcomes in PLWH.