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Evidence summaries

Deworming Helminth Co-Infected Individuals for Delaying HIV Disease Progression

Helminth eradication in HIV-1 and helminth co-infected adults may have beneficial effects on HIV-1 viral load and CD4 counts. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 3 studies with a total of 555 subjects. All of the included studies were conducted in Africa and included HIV-1-infected antiretroviral-naive individuals who were treated for different helminth infections (schistosomiasis, soil-transmitted helminths, and W. bancrofti) using different pharmaceutical interventions (praziquantel, albendazole, and diethylcarbamazine=DEC). The follow-up time was 3 months in all of the included studies.

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 demonstrated significant benefit of deworming on both plasma HIV-1 RNA (MD -0.18, 95% CI -0.33 to -0.03; 3 studies, n=349) and CD4 counts (MD -41.13, 95% CI -78.66 to -3.61; 2 studies, n=338). Mortality and clinical staging data were not consistently reported across studies.

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions) and by indirectness (short follow-up duration and lack of clinical staging and mortality data).

    References

    • Walson JL, Herrin BR, John-Stewart G. Deworming helminth co-infected individuals for delaying HIV disease progression. Cochrane Database Syst Rev 2009;(3):CD006419. [PubMed].

Primary/Secondary Keywords