HEPMAL Study

Hepatitis B virus (HBV) and Plasmodium are very common pathogens in sub-Saharan Africa and sometimes occur as co-infections. Both pathogens infect liver cells and elicit pathogen-specific immune responses that may mediate protection and immunopathology. HBV infection of the liver is usually long term, while Plasmodium liver infections are usually over a limited period after an infectious bite. Thus, immune responses against chronic HBV infections can affect liver-stage malaria-specific T cell responses. Nevertheless, there is no consensus on how HBV induced immune responses affect liver-stage anti-malarial immunity and vice versa. Also, malaria vaccine candidate trials usually exclude individuals infected with immune-modulating pathogens such as HBV. Nonetheless, vaccine-induced responses could be compromised in HBV-infected persons if malaria vaccines are later approved for routine immunization. This study established baseline data on the immunological and clinical outcomes of Plasmodium exposure in chronic HBV, leading to improved HBV monitoring, management and education.