Abstract #36  -  Deworming helminth and HIV co-infected individuals to delay disease progression; a systematic review and meta analysis
Authors:   Presenting Author:   Dr. Judd Walson - University of Washington
Additional Authors:  Dr. Judd Walson, Mr. Bradley Herrin, Dr. Grace John-Stewart,
Aim: The HIV-1 pandemic has disproportionately affected individuals in resource-constrained settings, where other infectious diseases, such as helminth infections, are also highly prevalent. There are biologically plausible reasons for possible effects of helminth infection in HIV-1 infected individuals and findings from multiple studies suggest that helminth infection may adversely affect HIV-1 progression. We sought to evaluate all currently available evidence to determine if treatment of helminth infection in HIV-1 co-infected individuals impacts HIV-1 progression.
Method / Issue: Using the methods of the Cochrane Collaboration, we searched online for published and unpublished randomized and quasi-randomized controlled trials that compared HIV-1 progression as measured by changes in CD4 count, viral load, or clinical disease progression in HIV-1 infected individuals receiving anti-helminthic therapy. We also searched databases listing conference abstracts, scanned reference lists of articles, and contacted authors of included studies.
Results / Comments: Of 7,019 abstracts identified, 17 abstracts were identified as meeting criteria for potential inclusion. After restricting inclusion to RCTs, a total of three studies were eligible for inclusion in this review. All three trials showed individual beneficial effects of helminth eradication on markers of HIV-1 disease progression (HIV-1 RNA and/or CD4 counts). When data from these trials were pooled, the analysis demonstrates significant benefit of deworming on both plasma HIV-1 RNA and CD4 counts.
Discussion: To date, three RCTs have evaluated the effects of deworming on markers of HIV-1 disease progression in helminth and HIV-1 co-infected individuals. All trials demonstrate benefit in attenuating or reducing plasma viral load and/or increasing CD4 counts. When taken together, there is evidence of benefit for deworming HIV-1 co-infected adults. Further trials are warranted to evaluate species-specific effects and to document long-term clinical outcomes following deworming.
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