{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:53:31Z","timestamp":1792788811024,"version":"4.5.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CANTAM","award":["CANTAM EPI3"],"award-info":[{"award-number":["CANTAM EPI3"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title\/>\n                    <jats:p>Malaria and HIV remain major public health challenges in sub-Saharan Africa. This study described the spectrum of malaria in people living with HIV (PLHIV) and HIV-negative adults in Gabon, where both diseases are endemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional study was conducted at the Centre Hospitalier Universitaire de Libreville from September 2021 to October 2022. Asymptomatic and febrile PLHIV and HIV negative volunteers were screened for malaria and\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      -infected individuals enrolled in the study. Data collected included socio-demographic characteristics, clinical presentation, cotrimoxazole use, antiretroviral treatment, and laboratory parameters, such as parasitaemia, haemoglobin levels and CD4\n                      <jats:sup>+<\/jats:sup>\n                      cell counts. Data from PLHIV and HIV-negative participants were compared using bivariate and multivariable logistic regression analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 1.192 individuals tested, 513 were PLHIV and 599 HIV-negative. Overall, 56\n                      <jats:italic>Plasmodium falciparum<\/jats:italic>\n                      -infected PLHIV and 66 HIV-negative individuals were enrolled. Asymptomatic malaria was more frequent among HIV-negative participants (60.6%\n                      <jats:italic>vs<\/jats:italic>\n                      25.0%), while severe malaria was significantly more common among HIV-positive patients (48.2%\n                      <jats:italic>vs<\/jats:italic>\n                      12.1%) (p\u2009&lt;\u20090.01). Prostration (16.7%), repeated seizures (14.3%), impaired consciousness (26.2%), severe anaemia (14.3%) and hypoglycemia (11.9%) predominated in PLHIV. Conversely, vomiting (26.9%) and high parasitemia (23.1%) were more frequent in HIV-negative patients. CTX chemoprophylaxis was associated with a reduction in\n                      <jats:italic>Plasmodium falciparum<\/jats:italic>\n                      parasitemia (\n                      <jats:italic>p\u2009=\u20090.03<\/jats:italic>\n                      ). The median CD4\u2009+\u2009cell count was significantly lower in PLHIV with severe malaria (150 [IQR: 90-204] cells\/\u00b5L) compared to those with asymptomatic (304 [IQR: 189-476] cells\/\u00b5L) (\n                      <jats:italic>p\u2009=\u20090.018<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared to HIV negative, asymptomatic malaria was less frequent while severe malaria predominantly affects PLHIV with advanced immunosuppression, highlighting the importance of early detection and management of co-infection to reduce morbidity. Further studies are needed to investigate the neurological manifestations and the impact of prophylactic strategies in Libreville.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0327068","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T18:46:51Z","timestamp":1771354011000},"page":"e0327068","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and biological features of complicated and asymptomatic malaria among PLHIV and HIV-negative adults: An observational study in Libreville, Gabon"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7811-2334","authenticated-orcid":true,"given":"Bridy Chesly","family":"Moutombi Ditombi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charleine","family":"Manomba Boulingui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ornella Ana\u00efse","family":"Mbang Nguema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coella Joyce","family":"Mihindou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bedrich","family":"Pongui Ngondza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques Mari","family":"Ndong Ngomo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magalie","family":"Essomeyo Mebale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mich\u00e8le-Marion","family":"Ntsame Owono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ardin Dimitri","family":"Mabicka Moussavou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Mayandza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4994-3355","authenticated-orcid":true,"given":"No\u00e9 Patrick","family":"Mbondoukw\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena Noeline","family":"Kono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marielle Karine","family":"Bouyou Akotet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"pone.0327068.ref001","author":"World malaria report 2024","year":"2024"},{"key":"pone.0327068.ref002","unstructured":"ONUSIDA. 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