Evaluation of Serum Clusterin and Uric Acid Levels in HIV Infected Patients with and without Malaria Infection in Nauth, Nnewi, Nigeria

Background: HIV continues to pose a major global health burden, particularly in developing countries, where its association with renal complications is becoming increasingly evident. The situation is further aggravated by malaria co-infection, which not only heightens mortality but also accelerates HIV-1 progression through CD4+ cell activation and pro-inflammatory cytokine upregulation. Despite this critical overlap, limited research has examined biochemical markers that may reflect or predict these complications. Aim: This study therefore evaluated serum clusterin and uric acid levels in HIV-infected patients, with and without malaria co-infection, at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, to provide insights into potential biomarkers for monitoring disease progression and co-morbidity outcomes. Methods: This case-controlled study involved eighty-eight participants, aged 18-65 years, recruited from the voluntary counseling and testing (VCT) and antiretroviral therapy (ART) units of NAUTH, Nnewi. Participants were randomly assigned to four groups (n=22 each): HIV positive without malaria, HIV positive with malaria, HIV negative with malaria, and HIV negative without malaria (control). Six milliliters of blood were collected from each participant for the determination of serum clusterin and uric acid levels using established laboratory methods. Statistical analysis was conducted using one-way analysis of variance (ANOVA) followed by a post-hoc t-test in SPSS version 25.0. Results: The findings revealed significantly higher serum clusterin (463.70±85.84 pmol/L) and uric acid (346.13±77.95 µmol/L) in HIV positive patients co-infected with malaria when compared to HIV seropositive subjects only and control subjects (p<0.05). Furthermore, clusterin levels were significantly elevated in males (422.16±89.11 pmol/L) compared to females (p<0.05). Notably, HIV subjects with CD4 counts of ≤500 cells/µL exhibited significantly higher clusterin (444.86±108.15 pmol/L) and uric acid (323.08±74.77 µmol/L) levels than those with CD4 counts >500 cells/µL (p<0.05). Conclusion: This study concludes that HIV-malaria co-infection is associated with a pronounced inflammatory reaction and hyperuricemia, indicative of heightened oxidative stress. These biochemical alterations signify an increased risk for renal dysfunction and disease severity among co-infected individuals.