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HIV and malaria severity — DTM&H MCQ

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ModerateHIV/AIDS in tropical settingsHIV and malaria severityDTM&H

A 38-year-old man with untreated HIV in Mozambique has falciparum malaria, higher parasite density than expected and severe anaemia. CD4 count is 90 cells/mm³. What is the most likely diagnosis?

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Correct answer: C — HIV-associated increased malaria severity

HIV-associated increased malaria severity is the single best answer because advanced HIV can increase malaria parasite density and risk of severe disease in endemic areas. Primaquine-induced relapse is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that coinfections should be considered, but the stem directly links immunosuppression with severe malaria phenotype.

Reference: WHO consolidated HIV guidelines; WHO advanced HIV disease guidance; Manson's Tropical Diseases