AEGiS-13IAC: Helminthic infections have a major impact on pathogenesis of AIDS and development of HIV protective vaccines in Africa and the developing world.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Helminthic infections have a major impact on pathogenesis of AIDS and development of HIV protective vaccines in Africa and the developing world.

Int Conf AIDS 2000 Jul 9-14; 13:24 (abstract no.. LbOr29)

Bentwich Z, Kalinkovich A, Borkow G, Quibin L, Wolday D, Maayan S, Landay A, Galai N, Weisman Z
AIDS Center, Rehovot, Israel. Fax: +972-89410461, E-mail: bentwich@agri.huji.ac.il.

BACKGROUND: We have suggested that helminthic infections make the host susceptible to HIV infection, less able to cope with it, and impaired in protective cellular immunity towards infections including HIV, because of the chronic immune activation (Immunol Today 16:187,1995; ibid 20:485,1999). The study of Ethiopian immigrants in Israel (ETI), formed the basis for this hypothesis. Study: Several groups of ETI, infected and non-infected by helminths and HIV, were studied sequentially, clinical and immunologically, and by multivariate analysis, before and after helminth eradication. The effects of deworming on Hiv plasma viral load (VL) were studied in HIV-helminths dually infected Ethiopians living in Ethiopia.

RESULTS: 1) Helminthic infections induce chronic immune activation with changed immune profile: a) low levels of CD4, naive and CD8/28 cells; b) elevated immune activation markers; c) anergy with diminished PPD skin reactivity; d) dominant TH2 immune profile. 2) Eradication of helminths, independent of changes in nutrition and environment, results in gradual normalization of immune profile and skin reactivity to PPD. 3) PBMC of ETI are more susceptible to HIV infection with increased expression of CCR5 and decreased beta chemokine secretion. 4) Stool egg excretion correlates with VL, and significant decrease of VL follows helminth eradication.

CONCLUSIONS: 1) Helminthic infections have a profound impact on host?s immunity due to chronic immune activation. 2) This immune activation makes the host more susceptible for HIV infection, increases VL with infection and impairs cellular immunity. 3) Together they account for rapid spread and progression of HIV infection in helminth infested regions, and will probably undermine HIV vaccine success. 4) Eradication of helminths is feasible, can be applied in Africa and the developing world, and have far reaching impact on the AIDS epidemic.

Keywords: AEGIS, AIDS Vaccines, Acquired Immunodeficiency Syndrome, Helminthiasis, HIV Infections, Africa, Chemokines, CC, Disease Outbreaks, Ethiopia, Israel, AIDS
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