HIV and helminths: time for a new direction

In the mid-1990s, in-vitro data suggested an immunological interaction between HIV and helminth co-infections. 1 Investigators subsequently tested the hypothesis that helminth infections adversely aff ect HIV disease progression. Initial small studies 2 suggested that in-vivo HIV viral load reductions correlated with helminth treatment. Reducing Th2 immunostimulation induced by helminth infection seemed to enhance HIV control, suggesting helminth treatment could be used as an adjunctive immunomodulation therapy. Subsequently, however, at least 12 observational studies and randomised controlled trials have not shown a consistent, clinically significant interaction between HIV and helminth infections. 3