7th Conference on Retroviruses and Opportunistic Infections San Francisco, CA - January 30 -February 4, 2000

Conf Retroviruses Opportunistic Infect 2000 Jan 30-Feb 2; 7:104 (abstract no. 157)

Wolday D, Maayan S, Mariam ZG, Britton S, Landay A, Bentwich Z; Armauer Hansen Res. Inst., Addis Ababa, Ethiopia.

BACKGROUND: We have previously suggested that helminthic infections play a major role as co-factors in the pathogenesis of HIV infection. We predicted that eradication of helminths would decrease HIV plasma viral load and thereby slow disease progression. Objectives: Determine HIV plasma viral load in HIV and helminth infected people before and after antihelminthic treatment. Methods and

RESULTS: A cohort of asymptomatic HIV-1-infected patients with helminthic infections was identified and characterized in Addis Ababa. Plasma HIV RNA viral load(Amplicor) as well as T lymphocyte subset counts, and immune activation markers, were determined before and after deworming by anti-helminthic chemotherapy. A total of 57 HIV-1 infected clinically asymptomatic people were enrolled. Of these, 32 (56%) were positive for one or more helminths. Before antihelminthic treatment, mean HIV viral load was higher in the helminth infected group,and a highly significant correlation was found between stool egg numbers and plasma HIV viral loads. However,no difference in CD4 levels and in immune activation was detected between the helminth infected and non infected groups. 3 and 6 months following eradication of helminthic infection by Albendazole, a highly significant relative decrease of HIV plasma viral loads was found in the helminth free but primarily infected group, in comparison to the helminth persistent and or helminth non infected groups, in whom there was either no change or relative increase in viral loads. Deworming was associated with significant reduction in immune activation, but with no change in CD4 counts.

CONCLUSIONS: 1) Eradication of helminthic infections leads to decreased HIV plasma viral load. 2)Deworming is a low-cost and effective treatment that may have a significant effect on progression of HIV infection, especially in developing countries where the vast majority of the population is infested with helminths and HAART is not available.

2000-01-30
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