Intestinal worm eradication lowers viral load in HIV-positive patients

Eradication of intestinal worms in HIV-positive patients living in Ethiopia leads to a decrease in viral load, according to a report in the 1 September issue of the Journal of AIDS.

“Helminthic infection affects a huge number of people in the world, and plays a very important role in making them more susceptible to HIV and tuberculosis and less able to mount a proper immune response. Thus, eradication of helminths may change the face of the AIDS and tuberculosis epidemics,” said Dr Zvi Bentwich.

Dr Bentwich, from Hebrew University Hadassah Medical School in Rehovot, Israel, and colleagues investigated whether treatment of helminthic infections would affect HIV disease progression in 56 otherwise asymptomatic HIV-positive Ethiopian patients – for whom antiretroviral treatment is unavailable and in whom helminthic infections are common.

Among the 31 patients with helminthic infections at baseline, there was a strong association between the helminthic load (as measured by the amount of eggs excreted in stools) and the HIV plasma viral load, the authors report.

Antihelminthic treatment clearly reduced the proportion of helminth-infected patients and the helminthic load in patients infected at baseline. According to the report, the successful treatment of helminthic infection was associated with a significant decrease in HIV levels, while the group of patients whose helminthic infections were not eradicated experienced a significant increase in mean HIV load.

“The decrease in HIV viral load, even of 0.35 logs only, is expected to have a very significant impact on the spread of the epidemic in the developing countries,” Dr Bentwich commented.

CD4+ T-lymphocyte counts did not change significantly during the course of the six-month study, the results indicate.

“In the absence of antiretroviral therapy in Africa, and the serious problems of compliance to ART even if it was available, eradication of helminths is a very attractive, simple, cheap and feasible measure to curb HIV infection,” Dr. Bentwich concluded.