Prevalence and Correlates of Helminth Co-infection in Kenyan HIV-1 Infected Adults

Overview

Journal PLoS Negl Trop Dis

Specialties Infectious Diseases
Tropical Medicine

Date 2010 Apr 3

PMID 20361031

Citations 32

Authors

Judd L Walson

Barclay T Stewart

Laura Sangare

Loice W Mbogo

Phelgona A Otieno

Benjamin K S Piper

Barbra A Richardson

Grace John-Stewart

Affiliations

Soon will be listed here.

Abstract

Background: Deworming HIV-1 infected individuals may delay HIV-1 disease progression. It is important to determine the prevalence and correlates of HIV-1/helminth co-infection in helminth-endemic areas.

Methods: HIV-1 infected individuals (CD4>250 cells/ul) were screened for helminth infection at ten sites in Kenya. Prevalence and correlates of helminth infection were determined. A subset of individuals with soil-transmitted helminth infection was re-evaluated 12 weeks following albendazole therapy.

Results: Of 1,541 HIV-1 seropositive individuals screened, 298 (19.3%) had detectable helminth infections. Among individuals with helminth infection, hookworm species were the most prevalent (56.3%), followed by Ascaris lumbricoides (17.1%), Trichuris trichiura (8.7%), Schistosoma mansoni (7.1%), and Strongyloides stercoralis (1.3%). Infection with multiple species occurred in 9.4% of infections. After CD4 count was controlled for, rural residence (RR 1.40, 95% CI: 1.08-1.81), having no education (RR 1.57, 95% CI: 1.07-2.30), and higher CD4 count (RR 1.36, 95% CI: 1.07-1.73) remained independently associated with risk of helminth infection. Twelve weeks following treatment with albendazole, 32% of helminth-infected individuals had detectable helminths on examination. Residence, education, and CD4 count were not associated with persistent helminth infection.

Conclusions: Among HIV-1 seropositive adults with CD4 counts above 250 cells/mm(3) in Kenya, traditional risk factors for helminth infection, including rural residence and lack of education, were associated with co-infection, while lower CD4 counts were not.

Citing Articles

Infection with soil-transmitted helminths and their impact on coinfections.

Schlosser-Brandenburg J, Midha A, Mugo R, Ndombi E, Gachara G, Njomo D Front Parasitol. 2025; 2():1197956.

PMID: 39816832 PMC: 11731630. DOI: 10.3389/fpara.2023.1197956.

Prevalence of intestinal parasites in HIV/AIDS-infected patients with correlation to CD4+ T-cell count at hospital in Eastern India.

Seema K, Kumar A, Boipai M, Kumar M, Sharma A J Family Med Prim Care. 2024; 12(11):2884-2887.

PMID: 38186830 PMC: 10771173. DOI: 10.4103/jfmpc.jfmpc_806_23.

Soil-transmitted helminths: A critical review of the impact of co-infections and implications for control and elimination.

Lebu S, Kibone W, Muoghalu C, Ochaya S, Salzberg A, Bongomin F PLoS Negl Trop Dis. 2023; 17(8):e0011496.

PMID: 37561673 PMC: 10414660. DOI: 10.1371/journal.pntd.0011496.

Prevalence of soil-transmitted helminth infections in HIV patients: a systematic review and meta-analysis.

Akanksha K, Kumari A, Dutta O, Prasanth A, Deeba F, Salam N Sci Rep. 2023; 13(1):11055.

PMID: 37422549 PMC: 10329649. DOI: 10.1038/s41598-023-38030-y.

Strongyloides stercoralis.

Czeresnia J, Weiss L Lung. 2022; 200(2):141-148.

PMID: 35396957 PMC: 8994069. DOI: 10.1007/s00408-022-00528-z.

References

Modjarrad K, Zulu I, Redden D, Njobvu L, Freedman D, Vermund S . Prevalence and predictors of intestinal helminth infections among human immunodeficiency virus type 1-infected adults in an urban African setting. Am J Trop Med Hyg. 2005; 73(4):777-82. PMC: 2749260. View

Tarimo D, Killewo J, Minjas J, Msamanga G . Prevalence of intestinal parasites in adult patients with enteropathic AIDS in north-eastern Tanzania. East Afr Med J. 1996; 73(6):397-9. View

Woodburn P, Muhangi L, Hillier S, Ndibazza J, Namujju P, Kizza M . Risk factors for helminth, malaria, and HIV infection in pregnancy in Entebbe, Uganda. PLoS Negl Trop Dis. 2009; 3(6):e473. PMC: 2696595. DOI: 10.1371/journal.pntd.0000473. View

Modjarrad K, Chamot E, Vermund S . Impact of small reductions in plasma HIV RNA levels on the risk of heterosexual transmission and disease progression. AIDS. 2008; 22(16):2179-85. PMC: 2661869. DOI: 10.1097/QAD.0b013e328312c756. View

Sher A, Gazzinelli R, Oswald I, Clerici M, Kullberg M, Pearce E . Role of T-cell derived cytokines in the downregulation of immune responses in parasitic and retroviral infection. Immunol Rev. 1992; 127:183-204. DOI: 10.1111/j.1600-065x.1992.tb01414.x. View

Bethony J, Brooker S, Albonico M, Geiger S, Loukas A, Diemert D . Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006; 367(9521):1521-32. DOI: 10.1016/S0140-6736(06)68653-4. View

de Silva N, Brooker S, Hotez P, Montresor A, Engels D, Savioli L . Soil-transmitted helminth infections: updating the global picture. Trends Parasitol. 2003; 19(12):547-51. DOI: 10.1016/j.pt.2003.10.002. View

Brooker S, Kabatereine N, Gyapong J, Stothard J, Utzinger J . Rapid mapping of schistosomiasis and other neglected tropical diseases in the context of integrated control programmes in Africa. Parasitology. 2009; 136(13):1707-18. PMC: 2777245. DOI: 10.1017/S0031182009005940. View

Wolday D, Mayaan S, Mariam Z, Berhe N, Seboxa T, Britton S . Treatment of intestinal worms is associated with decreased HIV plasma viral load. J Acquir Immune Defic Syndr. 2002; 31(1):56-62. DOI: 10.1097/00126334-200209010-00008. View

10.

Borkow G, Bentwich Z . Chronic immune activation associated with chronic helminthic and human immunodeficiency virus infections: role of hyporesponsiveness and anergy. Clin Microbiol Rev. 2004; 17(4):1012-30, table of contents. PMC: 523563. DOI: 10.1128/CMR.17.4.1012-1030.2004. View

11.

Knopp S, Mgeni A, Khamis I, Steinmann P, Stothard J, Rollinson D . Diagnosis of soil-transmitted helminths in the era of preventive chemotherapy: effect of multiple stool sampling and use of different diagnostic techniques. PLoS Negl Trop Dis. 2008; 2(11):e331. PMC: 2570799. DOI: 10.1371/journal.pntd.0000331. View

12.

van Eijk A, Lindblade K, Odhiambo F, Peterson E, Rosen D, Karanja D . Geohelminth Infections among pregnant women in rural western Kenya; a cross-sectional study. PLoS Negl Trop Dis. 2009; 3(1):e370. PMC: 2627942. DOI: 10.1371/journal.pntd.0000370. View

13.

Wiwanitkit V . Intestinal parasite infestation in HIV infected patients. Curr HIV Res. 2006; 4(1):87-96. DOI: 10.2174/157016206775197682. View

14.

Gassama A, Sow P, Fall F, Camara P, Gueye-Ndiaye A, Seng R . Ordinary and opportunistic enteropathogens associated with diarrhea in Senegalese adults in relation to human immunodeficiency virus serostatus. Int J Infect Dis. 2002; 5(4):192-8. PMC: 7128624. DOI: 10.1016/s1201-9712(01)90069-4. View

15.

Bachur T, Martins Vale J, Coelho I, Queiroz T, Chaves C . Enteric parasitic infections in HIV/AIDS patients before and after the highly active antiretroviral therapy. Braz J Infect Dis. 2008; 12(2):115-22. DOI: 10.1590/s1413-86702008000200004. View

16.

Weiss L, Donkova-Petrini V, Caccavelli L, Balbo M, Carbonneil C, Levy Y . Human immunodeficiency virus-driven expansion of CD4+CD25+ regulatory T cells, which suppress HIV-specific CD4 T-cell responses in HIV-infected patients. Blood. 2004; 104(10):3249-56. DOI: 10.1182/blood-2004-01-0365. View

17.

Walson J, Otieno P, Mbuchi M, Richardson B, Lohman-Payne B, Macharia S . Albendazole treatment of HIV-1 and helminth co-infection: a randomized, double-blind, placebo-controlled trial. AIDS. 2008; 22(13):1601-9. PMC: 2637615. DOI: 10.1097/QAD.0b013e32830a502e. View

18.

Actor J, Shirai M, Kullberg M, Buller R, Sher A, Berzofsky J . Helminth infection results in decreased virus-specific CD8+ cytotoxic T-cell and Th1 cytokine responses as well as delayed virus clearance. Proc Natl Acad Sci U S A. 1993; 90(3):948-52. PMC: 45787. DOI: 10.1073/pnas.90.3.948. View

19.

Brown M, Bukusuba J, Hughes P, Nakiyingi J, Watera C, Elliott A . Screening for intestinal helminth infestation in a semi-urban cohort of HIV-infected people in Uganda: a combination of techniques may enhance diagnostic yield in the absence of multiple stool samples. Trop Doct. 2003; 33(2):72-6. DOI: 10.1177/004947550303300206. View

20.

Hailemariam G, Kassu A, Abebe G, Abate E, Damte D, Mekonnen E . Intestinal parasitic infections in HIV/AIDS and HIV seronegative individuals in a teaching hospital, Ethiopia. Jpn J Infect Dis. 2004; 57(2):41-3. View