ASSOCIATION OF HEPATITIS-B SURFACE-ANTIGEN CARRIAGE WITH SEVERE MALARIA IN GAMBIAN CHILDREN

Severe malaria is a major cause of childhood mortality in sub-Saharan Africa but the factors predisposing children to Severe forms of malari a have not been fully elucidated. In a case-control study of over 1,20 0 Cambian children hepatitis B virus carriage was significantly increa sed amongst cases of severe malaria compared to matched controls. We s uggest,that this association may relate to impaired clearance of liver stage parasites in the presence of the reduced level of HLA class l a ntigen expression on hepatocytes Infected by hepatitis B virus. If thi s association is causal and viral carriage predisposes to severe malar ia, widespread vaccination against hepatitis B virus may reduce mortal ity from severe malaria.