title: Deworming of intestinal helminths reduces HIV-1 subtype C viremia in chronically co-infected individuals.
abstract: OBJECTIVE
  To define the impact of helminthic infestations and their treatment on viral load and T cell subsets in chronic HIV-1-infected patients.
  
  
  METHODS
  Two hundred twenty chronic HIV-1-infected Ethiopian patients with (N = 87) and without (N = 133) helminthic infestations were included. To determine the impact of deworming on viral load and T cell subsets, a subset of these patients with (n = 23) and without (n = 20) helminthic infestations were followed longitudinally. Helminth egg loads, plasma HIV RNA levels, and peripheral blood CD4(+) and CD8(+) T cells were determined at baseline and at 12 weeks after antihelminthic treatment.
  
  
  RESULTS
  At baseline, plasma viral load was significantly higher in individuals with (n = 87) than without (n = 133) a helminthic infestation (5.01 log10 vs. 3.41 log10, p < 0.001). Twelve weeks after antihelminthic treatment, plasma HIV RNA levels were reduced in the successfully treated group (p < 0.001). Twelve weeks after antihelminthic treatment, helminth infestations and their treatment had no significant effect on CD4(+) T cell counts. However, helminth-infested individuals had a higher level of CD8(+) T cells at baseline (p < 0.001), which was significantly reduced (p < 0.01) at 12 weeks after antihelminthic treatment.
  
  
  CONCLUSIONS
  Helminths were found to be associated with an increased HIV RNA level. Successful treatment of intestinal helminths reduced plasma HIV RNA levels in chronic HIV-1 subtype C infection. Considering the high endemicity of helminths in tropical settings, the management of chronically HIV-infected individuals must include deworming.
authors.affiliation: Institute of Virology, Leipzig University, Johannisallee 30, 04103 Leipzig, Germany; Department of Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. Electronic address: andargachewmulu.meharie@medizin.uni-leipzig.de.
authors.forename: Andargachew
authors.initials: A
authors.lastname: Mulu
authors.forename: Melanie
authors.initials: M
authors.lastname: Maier
authors.forename: Uwe Gerd
authors.initials: UG
authors.lastname: Liebert
mesh_terms: D000328:Adult; D000818:Animals; D000871:Anthelmintics / Q000494:pharmacology / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002908:Chronic Disease / Q000453:epidemiology; D060085:Coinfection / Q000097:blood / Q000453:epidemiology / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007422:Intestines / Q000469:parasitology; D008297:Male; D009349:Nematode Infections / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012555:Schistosomiasis mansoni / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000871:Anthelmintics; D012367:RNA, Viral
keywords: CD4(+) T cell; CD8(+) T cell; Deworming; HIV-1 subtype C; Viremia