Treatment of Intestinal Worms Is Associated With Decreased HIV Plasma Viral Load

Wolday, Dawit; Mayaan, Shlomo; Mariam, Zeru G.; Berhe, Nega; Seboxa, Teshale; Britton, Sven; Galai, Noya; Landay, Alan; Bentwich, Zvi

doi:10.1097/00126334-200209010-00008

Cited by 124 publications

(111 citation statements)

References 29 publications

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“…A similar relation between treatment and HIV viral load was seen in a small study of anthelmintic treatment in Ethiopia. 23 The magnitude of CD4-cell count decline before cotrimoxazole prophylaxis was greater in our study than in some others. Possible reasons include the burden of opportunistic infections in Africa or a high degree of illness among individuals joining an AIDS organisation, which could potentially lead to induction of the inflection point after which immune and virological status rapidly worsen.…”

Section: Discussioncontrasting

confidence: 50%

Effect of co-trimoxazole prophylaxis on morbidity, mortality, CD4-cell count, and viral load in HIV infection in rural Uganda

et al. 2004

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SummaryBackground Prophylaxis with co-trimoxazole (trimethoprim-sulphamethoxazole) is recommended for people with HIV infection or AIDS but is rarely used in Africa. We assessed the effect of such prophylaxis on morbidity, mortality, CD4-cell count, and viral load among people with HIV infection living in rural Uganda, an area with high rates of bacterial resistance to co-trimoxazole.Methods Between April, 2001, and March, 2003, we enrolled, and followed up with weekly home visits, 509 individuals with HIV-1 infection and their 1522 HIV-negative household members. After 5 months of follow-up, HIV-positive participants were offered daily co-trimoxazole prophylaxis (800 mg trimethoprim, 160 mg sulphamethoxazole) and followed up for a further 1·5 years. We assessed rates of malaria, diarrhoea, hospital admission, and death. Findings Co-trimoxazole was well tolerated with rare (<2% per person-year) adverse reactions. Even though rates of resistance in diarrhoeal pathogens were high (76%), co-trimoxazole prophylaxis was associated with a 46% reduction in mortality (hazard ratio 0·54 [95% CI 0·35-0·84], p=0·006) and lower rates of malaria (multivariate incidence rate ratio 0·28 [0·19-0·40], p<0·0001), diarrhoea (0·65 [0·53-0·81], p<0·0001), and hospital admission (0·69 [0·48-0·98], p=0·04). The annual rate of decline in CD4-cell count was less during prophylaxis than before (77 vs 203 cells per µL, p<0·0001), and the annual rate of increase in viral load was lower (0·08 vs 0·90 log 10 copies per mL, p=0·01).Interpretation Daily co-trimoxazole prophylaxis was associated with reduced morbidity and mortality and had beneficial effects on CD4-cell count and viral load. Co-trimoxazole prophylaxis is a readily available, effective intervention for people with HIV infection in Africa.

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Section: Discussioncontrasting

confidence: 50%

Effect of co-trimoxazole prophylaxis on morbidity, mortality, CD4-cell count, and viral load in HIV infection in rural Uganda

et al. 2004

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Section: Introductionmentioning

confidence: 99%

“…On the other hand, the progressing development of AIDS in HIV is a risk factor for the acquisition of other infective agents including parasites which are the proximate cause of death of AIDS patients [15,16,17]. The effect of intestinal parasites on the HIV RNA levels is not clear either with reports suggesting that treatment of intestinal parasitic infections may reduce HIV RNA levels [18].Whatever the outcome may be of intestinal parasitic and HIV co-infection, it is obvious that co-infection between these pathogens is common particularly in developing countries where the factors favoring transmission of parasites are all in place This negatively impacts on the health status and outlook of people living with HIV/AIDS [19]. Understanding the actual burden of intestinal parasites in HIV is therefore imperative in improving on the management of HIV/AIDS.…”

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confidence: 99%

Prevalence and Predisposing Factors to Intestinal Parasitic Infections in HIV/AIDS Patients in Fako Division of Cameroon

Nsagha

Njunda²,

Nguedia³

et al. 2017

AJEID

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Background: Understanding the epidemiology of intestinal parasitic infection is essential for the effective management of HIV infection in areas where intestinal parasites are also endemic. Data on the prevalence of intestinal parasitic infection in people living with HIV/AIDS (PLHWA) in Cameroon are sparse. This study was designed to determine the prevalence of intestinal parasitic infections, as well as assess the predisposing factors for the infection in PLHWA in Fako Division of Cameroon. Methods: This was a cross-sectional study conducted between April and July 2014. Stool specimen were collected from consented participants and examined for ova, cysts, larvae or oocytes using the Kato-Katz, Formalin-Ether Concentration, Modified Ziehl-Neelsen and Modified field staining techniques. Statistical analysis performed included the Chi-square test and logistic regression. P<0.05 was considered to be statistically significant. Results: At the end of the study, 300 participants were enrolled, the majority being females 236 (78.6%). The participants were between 21-70 years (mean±SD = 40±10) of age. The overall prevalence of intestinal parasites was 82.6% (95% CI: 78.4 -87.0). The prevalence of infection was associated with age, being more prevalent in the age group 51-60 years (p=0.032). Intestinal protozoa were more prevalent than intestinal helminthes (74.3% vs 11.3%). The parasites isolated included: Cryptosporidium parvum (44.0%), Blastocystis hominis (25.0%), Microsporidium spp. (21.0%), Entamoeba histolytica (7.3%), Ascaris lumbricoïdes (4.3%), Isospora belli (4.3%), Trichuris trichiura (2.3%), hookworm (2.7%), Hymenolepis nana (1.3%), Strongyloïdes stercoralis (0.7%), Cyclospora cayetatensis (3.7%) and Giardia lamblia (3.3%). The predisposing factors for infection with intestinal parasites included poor educational background (OR=0.33, p=0.02), unskilled worker (OR=0.27, p=0.04), well as a source of drinking water (OR=2.6, p=0.03), and living with cats as pets (OR=3.06, p=0.01). Conclusion: A very high prevalence of intestinal parasitic infection was observed in PLHWA. Major predisposing factors for intestinal parasites infection included primary level of education, ownership of cats as pets, wells as source of drinking water and having a blue collar job. Routine screening for intestinal parasites should be instituted as part of HIV care in Fako division of Cameroon to improve on the management of HIV. HIV, protozoa, helminthes, prevalence, predisposing factors, Fako Division, cameroon Keywords: BackgroundIntestinal parasites are highly endemic in Sub-Saharan Africa [1], a region which is currently experiencing the highest burden of HIV/AIDS [1]. With the overlap in the distribution of both diseases, co-infection with one or more intestinal parasites and HIV is therefore common in the region [2]. The incidence of Intestinal parasitic infections is approximately 50% in developed countries whereas it reaches up to 95% in developing countries [2]. Cameroon is among the Sub-Saharan African countries...

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“…No intergroup differences were found in the surface expression of HLA-DR, CD25, CCR5, CXCR4, CCR3 on CD4 T cells, or monocytes before infection. PBMC from filarial-infected patients produced less Regulated on Activation; Normal T Cell Expressed and Secreted (RANTES) (P = .02) but more intracellular interleukin-4 than those of control subjects (13) . Thus, PBMC from persons with filarial infections appears to have enhanced susceptibility to HIV-1 infection mediated by an undetermined mechanism (14) .…”

Section: Discussionmentioning

confidence: 93%

“…Memory was greatly improved, the irrational talk was no more, and the swollen lymphedematous limbs greatly subsided. Previous studies have shown trends toward increased HIV replication in the peripheral blood mononuclear cell (PBMC) from filarial-infected patients (12,13) . Furthermore, PBMC from 6 filarial-infected patients before anti-filarial treatment were significantly more susceptible to replication of M-tropic virus than their post-treatment PBMC (P = .03).…”

Section: Discussionmentioning

confidence: 99%

Human Immunodeficiency Virus and Wuchereria Bancrofti Co-infection in Southern Nigeria: A Case Report

Ibeanusi

2017

IAM

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A 66-year-old male patient presented with irrational talks of 6 weeks duration and bilateral leg swelling of 2 years duration. The patient was a known hypertensive and diabetic. His Serum filarial test was very significant, and his brain Computerized Tomography scan showed cerebral atrophy. An assessment of stage 4 HIV (AIDS) was made in the background of filariasis. His Packed Cell Volume, White Blood Cell count, and Liver Function Tests were all within normal limits. Diethylcarbamazine was added to the patient HAART medication. Limb hygiene, elevation, and compressive bandage were also commenced for the swollen limbs. Two weeks into admission, a remarkable improvement was noticed. His memory was greatly improved. The irrational talk was no more, as he engaged incoherent discussions. The swelling of the limbs was greatly subsided. The patient was later discharged home after three weeks on admission to continue his treatment on an out-patient basis.

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Treatment of Intestinal Worms Is Associated With Decreased HIV Plasma Viral Load

Cited by 124 publications

References 29 publications

Effect of co-trimoxazole prophylaxis on morbidity, mortality, CD4-cell count, and viral load in HIV infection in rural Uganda

Effect of co-trimoxazole prophylaxis on morbidity, mortality, CD4-cell count, and viral load in HIV infection in rural Uganda

Prevalence and Predisposing Factors to Intestinal Parasitic Infections in HIV/AIDS Patients in Fako Division of Cameroon

Human Immunodeficiency Virus and Wuchereria Bancrofti Co-infection in Southern Nigeria: A Case Report

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