Forschen Sci Open HUB for Scientific Research International Journal of Vaccines and Immunization Open Access Copyright: © 2015 Gasim GI, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Volume: 1.1 Mini Review Hepatitis B Hepatitis C virus and Malaria co- infection Gasim I Gasim 1 and Ishag Adam 1,2 * 1 Qassim College of Medicine, Qassim University, Saudi Arabia 2 Faculty of Medicine, University of Khartoum, Sudan Received date: 20 July 2015; Accepted date: 12 August 2015; Published date: 15 August 2015. Citation: Gasim GI, Adam I (2015) Hepatitis B Hepatitis C virus and Malaria co-infection. Int J Vaccine Immunizat 1(1): doi: http://dx.doi. org/10.16966/2470-9948.101 Copyright: © 2015 Gasim GI, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. * Corresponding author: Ishag Adam, MD, PhD, Faculty of Medicine, University of Khartoum, P.O. Box 102, Khartoum, Sudan, Tel: +249912168988, E-mail: ishagadam@hotmail.com Abstract Background: Malaria remains a major health threat worldwide. Endemic regions for malaria are endemic for other infectious diseases that might affect the malaria infection. Methods: A systematic search was conducted where it included published data about HBV, HCV and malaria. Published data on epidemiology, pathogenesis and consequences of HBV, HCV and malaria, were extracted from relevant studies. Epidemiology of co-infection has not been well studied, and studies in this concern will defnitely draw the attention of decision makers towards such problem. Results: Younger age and male gender were risk factors for co-infection. There were no protective effects of HBV vaccine against malaria. The interaction between malaria parasites and HCV among chronic HCV carriers might slow the emergence of the former and that could help in determining new therapeutic approaches to defeat malaria. Conclusion: Strategies to improve currently available diagnostic techniques, researches dealing with therapeutic and prophylactic agents and protocols, vector control procedures, vaccine bringing up evolution, and other operational tools and approaches are needed. Keywords: Malaria; Endemic; Hepatotropic; Vaccine; Hepatitis B Introduction Malaria remains a major health threat worldwide. Endemic regions for malaria are also endemic for other infectious diseases that might afect the malaria infection [1]. Examples for such a common endemic infection sharing the same territory with malaria are hepatitis B virus (HBV) and hepatitis C (HCV) [2-4]. HBV stimulates a potent pro- infammatory Type 1 immune response (T1), which is of paramount importance for Plasmodium clearance; however, it is also incriminated in disease severity [5]. Whilst challenging, data on the efects of HBV on the clinical presentation of malaria are scarce. Pasquetto et al. demonstrated in a mice model that intra hepatic HBV replication is inhibited by P. yoelii infection [6], moreover, production of interferon (IFN)-c and IFN-a/b is increased in the liver. In humans, information from a small study proposes that acute P. falciparum malaria alters HBV viremia in patients with chronic HBV infection [7]. Moreover, a study carried in Vietnam illustrated that patients with cerebral malaria had a slightly greater vulnerability to demonstrate HBV surface antigen (HBsAg) sero-positivity [8]; nevertheless, the aforementioned study failed to show any signifcant relation between the overall risk of death caused by severe falciparum malaria and positivity for HBs Ag [8]. However, there is lack of strong evidence supporting the suggestion that the clinical status of underlying hepatitis B-related liver disease is afected during malaria infection. On speaking about hepatitis C, Ouwe-Missi-Oukem- Boyer found an interaction between malaria parasites and HCV among chronic HCV carriers leading to slower emergence of the former [9]. Furthermore, having the three infections sharing an intra-hepatic stage as part of their life cycles, interactions between the three pathogens have been proposed to occur at both immunological and cellular levels, not only this but on looking at their epidemiological maps, a clear intersection is seen between the areas of endemicity of the three pathogens, please see Figure1. Such interactions between HBV and malaria have already been demonstrated in a mice model [8]. It is intriguing, that all three pathogens may also utilize common receptors amid the hepatocyte invasion [10- 12]. Furthermore, the impact of HBV and HCV infection on the clinical picture of malaria has not been adequately addressed. In this review, we aimed at putting together published data and analyzing it in order to come out with a clear picture about the pathophysiology, clinical presentation, and future prospects. Methods Asystematic search was conducted where it included published data about HBV, HCV and malaria. Published data about epidemiology, pathogenesis and repercussions of HBV, HCV and malaria, were extracted from relevant studies. Te databases were searched using the words “Hepatitis B virus”, ‘Hepatitis C Virus” , “malaria HCV co-infection”, “epidemiology”, “Africa” , “South America”, “Asia” and occasionally, names of particular countries where entered interchangeably utilizing diferent search engines such as MEDLINE, Pubmed, MiPc library and Google. Epidemiology and risk factors Epidemiology of hepatitis B virus and malaria co-infection has not been well studied; some studies found that co-infection existed among about 41% out of 337 blood donors [13], nevertheless, the study was weak in methodology where no obvious inclusion or exclusion criteria were set, furthermore, the was not among the general population. Another study found the prevalence among Brazilian general population was as high as 1.8% [14]. Omalu et al. found a prevalence of 7.8% among a group of pregnant Nigerian women [15], this study was also defective in methodology as no clear criteria for selection or exclusion were set, and the pregnant women might be more vulnerable than the general population. On the other hand a study conducted by Pakistani investigators found no ISSN 2470-9948