Intestinal helminth infections amongst HIV-infected adults in Mthatha General Hospital, South Africa

Abstract

BackgroundIn South Africa, studies on the prevalence of intestinal helminth co-infection amongst HIV-infected patients as well as possible interactions between these two infections are limited.AimTo investigate the prevalence of intestinal helminth infestation amongst adults living with HIV or AIDS at Mthatha General Hospital.SettingStudy participants were recruited at the outpatient department of Mthatha General Hospital, Mthatha, South Africa.MethodsThis cross-sectional study was conducted between October and December 2013 amongst consecutive consenting HIV-positive adult patients. Socio-demographic and clinical information were obtained using data collection forms and structured interviews. Stool samples were collected to investigate the presence of helminths whilst blood samples were obtained for the measurement of CD4+ T-cell count and viral load.ResultsData were obtained on 231 participants, with a mean age of 34.9 years, a mean CD4 count of 348 cells/µL and a mean viral load of 4.8 log10 copies/mL. Intestinal helminth prevalence was 24.7%, with Ascaris Lumbricoides (42.1%) the most prevalent identified species. Statistically significant association was found between CD4 count of less than 200 cells/µL and helminth infection (p = 0.05). No statistically significant association was found between intestinal helminth infection and the mean CD4 count (p = 0.79) or the mean viral load (p = 0.98).ConclusionA high prevalence of intestinal helminth infections was observed amongst the study population. Therefore, screening and treatment of helminths should be considered as part of the management of HIV and AIDS in primary health care.

A review of the traditional use of southern African medicinal plants for the treatment of selected parasite infections affecting humans

“…Even postnatal, maternal infestation may cause lethargy and malaise which may adversely affect the mothers' ability to provide adequate care for the infant. Of further concern, some parasitic diseases may accelerate the progression of the human immunodeficiency virus (HIV) infections in pregnant women to the end stage of the disease (Adeleke et al, 2015). Whilst this is not only a concern for pregnant HIV sufferers, the affects may be more evident due to alterations in the maternal immune responses that occur during pregnancy.…”

Selected aspects of helminth infections Schistosoma sp., Ascaris lumbricoides, Strongyloides stercoralis in individuals diagnosed with human immunodeficiency virus (HIV) infection

“…It is interesting that in patients on antiretroviral therapy a significant decrease in prevalence of several helminth species (T. trichura, A. lumbricoides and S. stercoralis, Schistosoma spp.) was observed (11,28,60,73). Improvement of patient immune system function plays thus an important role in limitation/ elimination of infections with the analysed parasite species.…”

“…Wyniki niektórych badań wskazują, że skutkiem HAART, oprócz zmniejszenia poziomu wiremii HIV, jest spadek poziomu przeciwciał IgE. Stanowi to przesłankę, że HIV jest jednym z czynników aktywujących wytwarzanie IgE (39,60,72,73,74).…”

“…Stosowanie leków przeciwko helmintom, np. albendazolu, powoduje przesunięcie typu odporności w kierunku Th1, która ma kluczowe znaczenie w odpowiedzi immunologicznej przeciwko HIV (60). Przy równoczesnym stosowaniu terapii skierowanej przeciwko zarażeniom pasożytami i HIV uzyskuje się lepszy efekt terapii antyretrowirusowej (2).…”

“…The results of some studies revealed that, apart from a decrease in HIV viraemia levels, the HAART therapy causes a decrease in IgE antibody levels. This leads to a conclusion that HIV is one of the factors that promote IgE production (39,60,72,73,74).…”