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Effect of deworming on Th2 immune response during HIV-helminths co-infection.

Mulu A, Anagaw B, Gelaw A, Ota F, Kassu A, Yifru S - J Transl Med (2015)

Bottom Line: However, there was no significant decrease in serum IgE level among asymptomatic HIV infected individuals (1,183 versus 1,097 IU/ml, P = 0.13) and apparently health controls (666 IU/ml versus 571, P = 0.09) without helminths co-infection 12 weeks after deworming.The significant decline of serum IgE level 12 weeks after deworming of both symptomatic and asymptomatic patients indicate a tendency to down-regulate the Th2 immune response and is additional supportive evidence that deworming positively impacts HIV/AIDS diseases progression.Thus, deworming should be integrated with ART program in helminths endemic areas of tropical countries.

View Article: PubMed Central - PubMed

Affiliation: Department of Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. andargachewmulu@yahoo.com.

ABSTRACT

Background: Helminths infections have been suggested to worsen the outcome of HIV infection by polarizing the immune response towards Th2. The purpose of this study is to determine the activity of Th2 immune response by measuring total serum IgE level during symptomatic and asymptomatic HIV infection with and without helminths co-infection and to define the role of deworming and/or ART on kinetics of serum IgE.

Methods: This prospective comparative study was conducted among symptomatic HIV-1 infected adults, treatment naïve asymptomatic HIV positive individuals and HIV negative apparently healthy controls with and without helminths co-infection. Detection and quantification of helminths and determination of serum IgE level, CD4(+), and CD8(+) T cell count were done at baseline and 12 weeks after ART and/or deworming.

Results: HIV patients co-infected with helminths showed a high level of serum IgE compared to HIV patients without helminths co-infection (1,688 [IQR 721-2,473] versus 1,221 [IQR 618-2,289] IU/ml; P = 0.022). This difference was also markedly observed between symptomatic HIV infected patients after with and without helminths infection (1,690 [IQR 1,116-2,491] versus 1,252 [703-2,251] IU/ml; P = 0.047). A significant decline in serum IgE level was observed 12 weeks after deworming and ART of symptomatic HIV infected patients with (1,487 versus 992, P = 0.002) and without (1,233 versus 976 IU/ml, P = 0.093) helminths co-infection. However, there was no significant decrease in serum IgE level among asymptomatic HIV infected individuals (1,183 versus 1,097 IU/ml, P = 0.13) and apparently health controls (666 IU/ml versus 571, P = 0.09) without helminths co-infection 12 weeks after deworming.

Conclusions: The significant decline of serum IgE level 12 weeks after deworming of both symptomatic and asymptomatic patients indicate a tendency to down-regulate the Th2 immune response and is additional supportive evidence that deworming positively impacts HIV/AIDS diseases progression. Thus, deworming should be integrated with ART program in helminths endemic areas of tropical countries.

No MeSH data available.


Related in: MedlinePlus

Cohort of HIV-1 infected individuals with helmitnhs and without helminths infection included in the study. Keys: ART- Antiretroviral drugs, AH- Antihelminthic drug.
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Fig1: Cohort of HIV-1 infected individuals with helmitnhs and without helminths infection included in the study. Keys: ART- Antiretroviral drugs, AH- Antihelminthic drug.

Mentions: This prospective comparative study was conducted at University Gondar Hospital, northwest Ethiopia among symptomatic HIV-1 infected adults at initiation of ART [with (N = 40) and without (N = 20) helminths co-infection], asymptomatic HIV positive individuals [with (N = 20) and without (N = 25) helminths co-infection] and HIV negative apparently healthy controls [with (N = 10) and without (N = 15) helminths co-infection]. The cohort profile is summarized in Figure 1. Patients enrolment was as follows: On one hand, consecutive clinically symptomatic patients with known HIV serostatus above 18 years of age, seeking treatment and willing to participate were evaluated with a standardized form at enrolment. On the other hand, detailed clinical history and complete physical examination including for any clinical signs as the WHO clinical staging of HIV infection were made for asymptomatic patients and enrolled when only if they were clinically asymptomatic and had no previous AIDS-defining conditions. Patients were excluded for the following reasons or conditions: pregnancy, treatment with single dose nevirapine for prevention of mother-to-child transmission of HIV or any other antiretroviral therapy (ART), known diabetes, hypertension, epilepsy, liver, cardiac and renal diseases, genital ulcer or active tuberculosis or atopic diseases (allergic asthma, allergic rhinitis or atopic dermatitis-according to self-reported and physician diagnosed allergy following the modified version of International Study of Asthma and Allergies module) at enrolment.Figure 1


Effect of deworming on Th2 immune response during HIV-helminths co-infection.

Mulu A, Anagaw B, Gelaw A, Ota F, Kassu A, Yifru S - J Transl Med (2015)

Cohort of HIV-1 infected individuals with helmitnhs and without helminths infection included in the study. Keys: ART- Antiretroviral drugs, AH- Antihelminthic drug.
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4506626&req=5

Fig1: Cohort of HIV-1 infected individuals with helmitnhs and without helminths infection included in the study. Keys: ART- Antiretroviral drugs, AH- Antihelminthic drug.
Mentions: This prospective comparative study was conducted at University Gondar Hospital, northwest Ethiopia among symptomatic HIV-1 infected adults at initiation of ART [with (N = 40) and without (N = 20) helminths co-infection], asymptomatic HIV positive individuals [with (N = 20) and without (N = 25) helminths co-infection] and HIV negative apparently healthy controls [with (N = 10) and without (N = 15) helminths co-infection]. The cohort profile is summarized in Figure 1. Patients enrolment was as follows: On one hand, consecutive clinically symptomatic patients with known HIV serostatus above 18 years of age, seeking treatment and willing to participate were evaluated with a standardized form at enrolment. On the other hand, detailed clinical history and complete physical examination including for any clinical signs as the WHO clinical staging of HIV infection were made for asymptomatic patients and enrolled when only if they were clinically asymptomatic and had no previous AIDS-defining conditions. Patients were excluded for the following reasons or conditions: pregnancy, treatment with single dose nevirapine for prevention of mother-to-child transmission of HIV or any other antiretroviral therapy (ART), known diabetes, hypertension, epilepsy, liver, cardiac and renal diseases, genital ulcer or active tuberculosis or atopic diseases (allergic asthma, allergic rhinitis or atopic dermatitis-according to self-reported and physician diagnosed allergy following the modified version of International Study of Asthma and Allergies module) at enrolment.Figure 1

Bottom Line: However, there was no significant decrease in serum IgE level among asymptomatic HIV infected individuals (1,183 versus 1,097 IU/ml, P = 0.13) and apparently health controls (666 IU/ml versus 571, P = 0.09) without helminths co-infection 12 weeks after deworming.The significant decline of serum IgE level 12 weeks after deworming of both symptomatic and asymptomatic patients indicate a tendency to down-regulate the Th2 immune response and is additional supportive evidence that deworming positively impacts HIV/AIDS diseases progression.Thus, deworming should be integrated with ART program in helminths endemic areas of tropical countries.

View Article: PubMed Central - PubMed

Affiliation: Department of Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. andargachewmulu@yahoo.com.

ABSTRACT

Background: Helminths infections have been suggested to worsen the outcome of HIV infection by polarizing the immune response towards Th2. The purpose of this study is to determine the activity of Th2 immune response by measuring total serum IgE level during symptomatic and asymptomatic HIV infection with and without helminths co-infection and to define the role of deworming and/or ART on kinetics of serum IgE.

Methods: This prospective comparative study was conducted among symptomatic HIV-1 infected adults, treatment naïve asymptomatic HIV positive individuals and HIV negative apparently healthy controls with and without helminths co-infection. Detection and quantification of helminths and determination of serum IgE level, CD4(+), and CD8(+) T cell count were done at baseline and 12 weeks after ART and/or deworming.

Results: HIV patients co-infected with helminths showed a high level of serum IgE compared to HIV patients without helminths co-infection (1,688 [IQR 721-2,473] versus 1,221 [IQR 618-2,289] IU/ml; P = 0.022). This difference was also markedly observed between symptomatic HIV infected patients after with and without helminths infection (1,690 [IQR 1,116-2,491] versus 1,252 [703-2,251] IU/ml; P = 0.047). A significant decline in serum IgE level was observed 12 weeks after deworming and ART of symptomatic HIV infected patients with (1,487 versus 992, P = 0.002) and without (1,233 versus 976 IU/ml, P = 0.093) helminths co-infection. However, there was no significant decrease in serum IgE level among asymptomatic HIV infected individuals (1,183 versus 1,097 IU/ml, P = 0.13) and apparently health controls (666 IU/ml versus 571, P = 0.09) without helminths co-infection 12 weeks after deworming.

Conclusions: The significant decline of serum IgE level 12 weeks after deworming of both symptomatic and asymptomatic patients indicate a tendency to down-regulate the Th2 immune response and is additional supportive evidence that deworming positively impacts HIV/AIDS diseases progression. Thus, deworming should be integrated with ART program in helminths endemic areas of tropical countries.

No MeSH data available.


Related in: MedlinePlus