Survival differences and artemisinin resistance in severe malaria among HIV coinfected patients: data from Mozambique

The study examined differences in treatment and antimalarial resistance in patients with severe malaria based on HIV infection status in Mozambique. A total of 149 adult patients aged 18-62 years were enrolled, with 59 (39.6%) having HIV coinfection. Patients with HIV coinfection had higher anemia rates and significantly higher mortality during hospitalization and 30 days post-discharge, with mortality inversely correlated to CD4 count. Overall mortality at the end of the study was 20.1%. Researchers found no increase in resistance in major antimalarial resistance-associated genes, but identified increased K189T pfkelch mutations (21.2% vs 2.7%) in HIV-infected patients. The results emphasize the need for effective treatment in this vulnerable population and the importance of continued surveillance of parasite resistance in Mozambique.