Can deworming delay immunosuppression in HIV?

In sub-Saharan Africa, co-infection with HIV-1 and helminths is very common, affecting the natural history and disease progression of both. However, the effects of interaction between the two infections are a contentious issue. Findings from various studies have shown impaired immune responses against HIV in individuals with helminth infections, suggesting a role for helminths in immunity attenuation, HIV pathogenesis, and accelerated disease progression. However, the complex interplay between the two infections in people living in poverty hampers identification of a causal relation. The association is beset with confounding factors that complicate the design of studies to define the effects of helminth infections on HIV disease progression. These factors include the bidirectional interaction between the two infections, the eff ects of other bacterial and viral infectious agents, malnutrition, and possible different immunological effects of different helminth species alone and in combination.