Immunological Responses to Helminths and HIV-1 Co-Infections

Helminth infections result from either ingestion or contact with contaminated fecal matter. To date, there is insufficient evidence as to whether helminths have influence on HIV-1 specific immune responses as literature results are indeterminate. We evaluated the effect of helminth infections on HIV disease progression through the monitoring of 2 outcomes: (1) plasma HIV-1 RNA Viral load (V/L) and (2) Cluster of Differentiation (CD4+) T-lymphocyte count amongst helminth-HIV-1 co-infected persons. We hypothesized that (1) concurrent helminth infections may damage immune control, resulting in escalating VL and reduced CD4+ T-lymphocyte count (2) and that, subject to successful treatment, a decrease in plasma VL could slow down disease progression. We reviewed 2032 citations, evaluated 432 abstracts, and read 10 articles (See PRISMA diagram). The methodologies were appraised using a Mixed Method Appraisal Tool (MMAT). At enrolment, plasma VL were significantly higher in individuals with helminths (5.01 log10 vs. 3.41 log10, p < 0.001). The magnitude of effect ranged from 5.28 log10 copies/mL at baseline and 4.67 log10 copies/mL, (p < 0.05) after treatment and a trend for 0.61 log10 lower VL. All but one RCT reported decline in plasma VL and significant interactions were seen in the successfully treated groups (p < 0.001). CD4+ T-lymphocyte count values were not significantly different in the co-infection groups relative to those with HIV-infection alone. This evidence supports that WaSH and HIV/AIDS co-programming could promote health of PLWHA. We suggest large scale trials for future studies. This systematic review registration number is CRD42022364296.