Effect of treating co-infections on HIV-1 viral load: a systematic review.
Co-infections contribute to HIV-related pathogenesis and often increase viral load in HIV-infected people. We did a systematic review to assess the effect of treating key co-infections on plasma HIV-1-RNA concentrations in low-income countries. We identified 18 eligible studies for review: two on tuberculosis, two on malaria, six on helminths, and eight on sexually transmitted infections, excluding untreatable or non-pathogenic infections. Standardised mean plasma viral load decreased after the treatment of co-infecting pathogens in all 18 studies. The standardised mean HIV viral-load difference ranged from -0.04 log(10) copies per mL (95% CI -0.24 to 0.16) after syphilis treatment to -3.47 log(10) copies per mL (95% CI -3.78 to -3.16) after tuberculosis treatment. Of 14 studies with variance data available, 12 reported significant HIV viral-load differences before and after treatment. Although many of the viral-load reductions were 1.0 log(10) copies per mL or less, even small changes in plasma HIV-RNA concentrations have been shown to slow HIV progression and could translate into population-level benefits in lowering HIV transmission risk.
Modjarrad
Kayvon
K
Department of Medicine, Vanderbilt University School of Medicine, Medical Center, 2525 West End Avenue, Nashville, TN, USA. kayvon.modjarrad@vanderbilt.edu
Vermund
Sten H
SH
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003141:Communicable Diseases / Q000150:complications* / Q000188:drug therapy; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D015497:HIV-1 / Q000302:isolation & purification*; D006561:Herpes Simplex / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008288:Malaria / Q000150:complications / Q000188:drug therapy; D010272:Parasitic Diseases / Q000150:complications / Q000188:drug therapy; D012367:RNA, Viral / Q000097:blood; D013587:Syphilis / Q000150:complications / Q000188:drug therapy; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy; D019562:Viral Load / Q000187:drug effects*
D044966:Anti-Retroviral Agents; D012367:RNA, Viral