Effects of malaria/helminthic coinfections on cervical cancer progression among sub Saharan African women on highly active antiretroviral therapy: A scoping review

Abstract

In Africa, the HIV prevalence in rural areas has begun to reach levels estimated within urban settings, where women are also more at risk for both malaria and intestinal parasitic infections. The objective of this review is to assess whether concomitant infections with malaria and/or helminthic diseases have an impact on cervical disease progression in women on HAART. This scoping review was conducted in August 2018. To conduct this scoping review, we searched the relevant studies in electronic databases such as PUBMED, Global Health, EMBASE, CINAHL and SCOPUS published in the year between 1960 and 2018 using the following search terms HAART AND malaria OR Helminth and Female OR women. Eight studies qualified for this review. The literature underscores the need for women on HAART with multiple co-infections to use adjuncts to retain immune recovery and undetectable HIV viral load, to reduce risk of cervical disease progression. A trend for higher risk of CIN3+ in HIV+ women reporting recent malarial infection was observed in one study. Given the public health impact of synergistic interactions between malaria and helminthic infections in HIV/HPV co-infected women on HAART, it is urgent that these interactions are elucidated.

Malaria and Helminthic Co-Infection during Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

“…Malaria and helminths co-infection causes elevated and unregulated inflammatory biomarkers such as C-reactive protein and serum level Hepcidin, which results in reduced iron absorption during pregnancy [41][42][43][44][45][46][47][48][49][50][51]. In addition, comorbidity of Plasmodium falciparum and helminthiasis elucidates the incidence of cervical cancer among pregnant women [52][53][54]. Moreover, during pregnancy, malaria co-infection with A. lumbricoides has been associated with an increased odds of P. falciparum infection [55,56], and malaria-Hookworm co-infection is associated with risks of increased Plasmodium parasitaemia [57,58].…”