Symptoms and Immune Markers in Plasmodium/Dengue Virus Co-infection Compared with Mono-infection with Either in Peru

Background: malaria and dengue are two of the most common vector-borne diseases in the world,but co-infection is rarely described,and immunologic comparisons of co-infection with mono-infection are lacking. methodology and principal findings: we collected symptom histories and blood specimens from subjects in a febrile illness surveillance study conducted in iquitos and puerto maldonado,peru,between 2002–2011. nineteen symptoms and 18 immune markers at presentation were compared among those with co-infection with plasmodium/dengue virus (denv),plasmodium mono-infection,and denv mono-infection. seventeen subjects were identified as having plasmodium/denv co-infection and were retrospectively matched with 51 denv mono-infected and 44 plasmodium mono-infected subjects. those with plasmodium mono-infection had higher levels of il-4,il-6,il-10,il-12,il-13,il-17a,ifn-γ,and mip1-α/ccl3 compared with denv mono-infection or co-infection; those with plasmodium mono-infection had more cough than those with denv mono-infection. subjects with denv mono-infection had higher levels of tgf-β1 and more myalgia than those with plasmodium mono-infection. no symptom was more common and no immune marker level was higher in the co-infected group,which had similar findings to the denv mono-infected subjects. conclusions/significance: compared with mono-infection with either pathogen,plasmodium/denv co-infection was not associated with worse disease and resembled denv mono-infection in both symptom frequency and immune marker level.