title: Treatment of intestinal helminths does not reduce plasma concentrations of HIV-1 RNA in coinfected Zambian adults.
abstract: BACKGROUND
  Infection with intestinal helminths may stimulate dysfunctional immune responses in human immunodeficiency virus (HIV)-infected persons. Studies have yielded conflicting results regarding the impact of antihelminthic treatment on plasma concentrations of HIV-1 RNA.Methods. We conducted a prospective study of 54 HIV-1- and helminth-coinfected and 57 HIV-1-infected, helminth-uninfected asymptomatic adults living in Lusaka, Zambia, to assess the impact of antihelminthic treatment on plasma concentrations of HIV-1 RNA.
  
  
  RESULTS
  Median baseline viral load was 0.33 log(10) copies/mL lower in the helminth-infected group than in the uninfected group. Mean viral load between pretreatment and posttreatment visits increased in the helminth-infected (mean, 4.23 vs. 4.29 log(10) copies/mL; P=.6) and helminth-uninfected (mean, 4.39 vs. 4.52 log(10) copies/mL; P=.2) groups. Helminth-infected participants with high pretreatment viral loads had a mean 0.25-log(10) copies/mL decrease after treatment (P=.3), and helminth-uninfected participants had a mean 0.02-log(10) copies/mL decrease (P=.8).
  
  
  CONCLUSIONS
  We did not find an overall association between treatment of intestinal helminth infections and reduction in viral load in coinfected adults. Future studies may need to focus on adults with intense helminth infections who live in rural areas or on adults or children who harbor higher helminth burdens and plasma concentrations of HIV-1 RNA.
authors.affiliation: Department of Epidemiology, University of Alabama, Birmingham, AL 35294-2170, USA. kmodjarrad@uasom.meis.uab.edu
authors.forename: Kayvon
authors.initials: K
authors.lastname: Modjarrad
authors.forename: Isaac
authors.initials: I
authors.lastname: Zulu
authors.forename: David T
authors.initials: DT
authors.lastname: Redden
authors.forename: Lungowe
authors.initials: L
authors.lastname: Njobvu
authors.forename: H Clifford
authors.initials: HC
authors.lastname: Lane
authors.forename: Zvi
authors.initials: Z
authors.lastname: Bentwich
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
mesh_terms: D000328:Adult; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006373:Helminthiasis / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000150:complications / Q000188:drug therapy*; D008297:Male; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood*; D016896:Treatment Outcome; D019562:Viral Load; D015024:Zambia
chemical_list: D000871:Anthelmintics; D012367:RNA, Viral