Treatment of intestinal helminths does not reduce plasma concentrations of HIV-1 RNA in coinfected Zambian adults

Background. Infection with intestinal helminths may stimulate dysfunctional immune responses in human immunodeficiency virus (HIV)-infected persons. Studies have yielded conflicting results regarding the impact of antihelminthic treatment on plasma concentrations of HIV-1 RNA. Methods. We conducted a prospective study of 54 HIV-1- and helminth-coinfected and 57 HIV-1-infected, helminth-uninfected asymptomatic adults living in Lusaka, Zambia, to assess the impact of antihelminthic treatment on plasma concentrations of HIV-1 RNA. Results. Median baseline viral load was 0.33 log₁₀ copies/mL lower in the helminth-infected group than in the uninfected group. Mean viral load between pretreatment and posttreatment visits increased in the helminth-infected (mean, 4.23 vs. 4.29 log₁₀ copies/mL; P = .6) and helminth-uninfected (mean, 4.39 vs. 4.52 log₁₀ copies/ mL; P = .2) groups. Helminth-infected participants with high pretreatment viral loads had a mean 0.25-log₁₀ copies/mL decrease after treatment (P = .3), and helminth-uninfected participants had a mean 0.02-log₁₀ copies/ mL decrease (P = .8). Conclusions. We did not find an overall association between treatment of intestinal helminth infections and reduction in viral load in coinfected adults. Future studies may need to focus on adults with intense helminth infections who live in rural areas or on adults or children who harbor higher helminth burdens and plasma concentrations of HIV-1 RNA.