Treatment of intestinal helminths does not reduce plasma concentrations of HIV-1 RNA in coinfected Zambian adults.
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.
Modjarrad
Kayvon
K
Department of Epidemiology, University of Alabama, Birmingham, AL 35294-2170, USA. kmodjarrad@uasom.meis.uab.edu
Zulu
Isaac
I
Redden
David T
DT
Njobvu
Lungowe
L
Lane
H Clifford
HC
Bentwich
Zvi
Z
Vermund
Sten H
SH
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
D000871:Anthelmintics; D012367:RNA, Viral