title: Effect of deworming on Th2 immune response during HIV-helminths co-infection.
abstract: BACKGROUND
  Helminths infections have been suggested to worsen the outcome of HIV infection by polarizing the immune response towards Th2. The purpose of this study is to determine the activity of Th2 immune response by measuring total serum IgE level during symptomatic and asymptomatic HIV infection with and without helminths co-infection and to define the role of deworming and/or ART on kinetics of serum IgE.
  
  
  METHODS
  This prospective comparative study was conducted among symptomatic HIV-1 infected adults, treatment naïve asymptomatic HIV positive individuals and HIV negative apparently healthy controls with and without helminths co-infection. Detection and quantification of helminths and determination of serum IgE level, CD4(+), and CD8(+) T cell count were done at baseline and 12 weeks after ART and/or deworming.
  
  
  RESULTS
  HIV patients co-infected with helminths showed a high level of serum IgE compared to HIV patients without helminths co-infection (1,688 [IQR 721-2,473] versus 1,221 [IQR 618-2,289] IU/ml; P = 0.022). This difference was also markedly observed between symptomatic HIV infected patients after with and without helminths infection (1,690 [IQR 1,116-2,491] versus 1,252 [703-2,251] IU/ml; P = 0.047). A significant decline in serum IgE level was observed 12 weeks after deworming and ART of symptomatic HIV infected patients with (1,487 versus 992, P = 0.002) and without (1,233 versus 976 IU/ml, P = 0.093) helminths co-infection. However, there was no significant decrease in serum IgE level among asymptomatic HIV infected individuals (1,183 versus 1,097 IU/ml, P = 0.13) and apparently health controls (666 IU/ml versus 571, P = 0.09) without helminths co-infection 12 weeks after deworming.
  
  
  CONCLUSIONS
  The significant decline of serum IgE level 12 weeks after deworming of both symptomatic and asymptomatic patients indicate a tendency to down-regulate the Th2 immune response and is additional supportive evidence that deworming positively impacts HIV/AIDS diseases progression. Thus, deworming should be integrated with ART program in helminths endemic areas of tropical countries.
authors.affiliation: Department of Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. andargachewmulu@yahoo.com.|Institute of Virology, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany. andargachewmulu@yahoo.com.
authors.forename: Andargachew
authors.initials: A
authors.lastname: Mulu
authors.affiliation: Department of Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. belayanagaw@gmail.com.
authors.forename: Belay
authors.initials: B
authors.lastname: Anagaw
authors.affiliation: Department of Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. aschalew3@gmail.com.
authors.forename: Aschalew
authors.initials: A
authors.lastname: Gelaw
authors.affiliation: Department of Preventive Environment and Nutrition, Graduate School of Nutrition and Bioscience, Institute of Health Biosciences, The University of Tokushima, Tokushima, 770-8503, Japan. ota-fusao@me.pikara.ne.jp.
authors.forename: Fuso
authors.initials: F
authors.lastname: Ota
authors.affiliation: Department of Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. afeworkkassu@yahoo.com.
authors.forename: Afework
authors.initials: A
authors.lastname: Kassu
authors.affiliation: Department of Pediatrics and Child Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. sisaydr@yahoo.com.
authors.forename: Sisay
authors.initials: S
authors.lastname: Yifru
mesh_terms: D000328:Adult; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology; D018414:CD8-Positive T-Lymphocytes / Q000166:cytology; D016022:Case-Control Studies; D060085:Coinfection / Q000276:immunology / Q000469:parasitology / Q000821:virology; D018450:Disease Progression; D005002:Ethiopia; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000469:parasitology; D006373:Helminthiasis / Q000276:immunology* / Q000628:therapy / Q000821:virology; D006376:Helminths; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D018655:Lymphocyte Count; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D018418:Th2 Cells / Q000166:cytology / Q000276:immunology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D007073:Immunoglobulin E; D015766:Albendazole