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HIV infection and tropical parasitic diseases - deleterious interactions in both directions?
Gundel Harms1, Hermann Feldmeier
1Institute of Tropical Medicine Berlin and Medical Faculty Charité, Humboldt-University Berlin, Germany. gundel.harms@charite.de
Abstract:
HIV and parasitic infections interact and affect each other mutually. Whereas HIV infection may alter the natural history of parasitic diseases, impede rapid diagnosis or reduce the efficacy of antiparasitic treatment, parasitoses may facilitate the infection with HIV as well as the progression from asymptomatic infection to AIDS. We review data on known interactions for malaria, leishmaniasis, Human African Trypanosomiasis, Chagas' disease, onchocerciasis, lymphatic filariasis, schistosomiasis and intestinal helminthiases. The common immunopathogenetic basis for the deleterious effects parasitic diseases may have on the natural history of HIV infection seems to be a particular type of chronic immune activation and a preferential activation of the T helper (Th)2 type of help. Control of parasitic diseases should complement the tools currently used in combating the HIV pandemic.
Insights
Parasitic infections worsen HIV disease progression by altering immune responses. Controlling parasitic diseases is crucial for managing the HIV pandemic effectively.
Area of Science:
- Immunology
- Infectious Diseases
- Public Health
Background:
- Human Immunodeficiency Virus (HIV) and parasitic infections have complex, bidirectional interactions.
- These interactions can negatively impact the natural course of both conditions, complicating diagnosis and treatment.
Purpose of the Study:
- To review the known interactions between HIV and various parasitic diseases.
- To elucidate the immunopathogenetic mechanisms underlying these detrimental effects.
- To emphasize the importance of parasitic disease control in HIV management.
Main Methods:
- Literature review of studies on HIV and parasitic infections.
- Analysis of data on specific parasitic diseases including malaria, leishmaniasis, and schistosomiasis.
- Examination of immunological pathways, specifically T helper cell responses.
Main Results:
- Parasitic infections can facilitate HIV acquisition and accelerate progression to Acquired Immunodeficiency Syndrome (AIDS).
- HIV infection can alter parasitic disease progression, hinder diagnosis, and reduce treatment efficacy.
- Chronic immune activation and a shift towards T helper (Th)2 responses are key mechanisms.
Conclusions:
- Parasitic diseases significantly worsen the prognosis of HIV infection.
- Integrated strategies controlling parasitic infections are essential complements to current HIV/AIDS interventions.
- Further research into shared immunopathogenetic pathways is warranted.