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Effect of Helminth Treatment on HIV Unclear

Review finds insufficient evidence to show benefit of anti-worm treatment in co-infections

WEDNESDAY, Dec. 26 (HealthDay News) -- Existing data is insufficient to establish the potential benefit of eradicating helminth infections in adults also infected with HIV-1; however, data from a handful of studies indicate that it may reduce plasma viral load. These findings were published Dec. 19 in PLoS Neglected Tropical Diseases.

Judd L. Walson, M.D., and Grace John-Stewart, M.D., of the University of Washington in Seattle, conducted a systematic literature review to evaluate evidence that treating helminth infection may decrease HIV-1 virus, reduce CD4 decline, or delay the onset of AIDS symptoms.

The investigators included one randomized controlled trial (RCT) and four observational studies. In the RCT, subjects with HIV-1 who were being treated for their schistosomiasis had a lower change in plasma HIV-1 RNA over three months than untreated subjects, but there were no significant differences in changes in CD4 counts or clinical staging between the groups. The observational studies also showed a trend toward benefit on HIV-1 RNA levels from helminth treatment, but no apparent benefit on CD4 count or mortality. Helminths in the observational studies included hookworm, Strongyloides stercoralis, Trichuris trichiura, and Ascaris lumbricoides.

"There is need for large randomized controlled trials with longer follow-up duration in order to assess the impact of de-worming on HIV-1 progression in populations with a high prevalence of both helminth and HIV-1 infection," the authors conclude.

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