Impact of Anti-Retroviral Treatment and Cotrimoxazole Prophylaxis on Helminth Infections in HIV-Infected Patients in Lambaréné,Gabon

Foci of the hiv epidemic and helminthic infections largely overlap geographically. treatment options for helminth infections are limited,and there is a paucity of drug-development research in this area. limited evidence suggests that antiretroviral therapy (art) reduces prevalence of helminth infections in hiv-infected individuals. we investigated whether art exposure and cotrimoxazole preventive therapy (ctx-p) is associated with a reduced prevalence of helminth infections. this cross-sectional study was conducted at a primary hiv-clinic in lambaréné,gabon. hiv-infected adults who were art-naïve or exposed to art for at least 3 months submitted one blood sample and stool and urine samples on 3 consecutive days. outcome was helminth infection with intestinal helminths,schistosoma haematobium,loa loa or mansonella perstans. multivariable logistic regression was used to assess associations between art or ctx-p and helminth infection. in total,408 patients were enrolled. helminth infection was common (77/252 [30.5%]). filarial infections were most prevalent (55/310 [17.7%]),followed by infection with intestinal helminths (35/296 [11.8%]) and s. haematobium (19/323 [5.9%]). patients on ctx-p had a reduced risk of loa loa microfilaremia (adjusted odds ratio (aor) 0.47,95% ci 0.23-0.97,p = 0.04),also in the subgroup of patients on art (aor 0.36,95% ci 0.13-0.96,p = 0.04). there was no effect of art exposure on helminth infection prevalence. ctx-p use was associated with a decreased risk of loa loa infection,suggesting an anthelminthic effect of antifolate drugs. no relation between art use and helminth infections was established. © 2015 janssen et al.