University of Washington, Department of Global Health, Box 359909, 325 Ninth Avenue Seattle, WA 98104, USA.
Parasitology. 2011 Oct;138(12):1546-58. doi: 10.1017/S0031182011000357. Epub 2011 May 18.
In sub-Saharan Africa, over 22 million people are estimated to be co-infected with both helminths and HIV-1. Several studies have suggested that de-worming individuals with HIV-1 may delay HIV-1 disease progression, and that the benefit of de-worming may vary by individual helminth species. We conducted a systematic review and meta-analysis of the published literature to determine the effect of treatment of individual helminth infections on markers of HIV-1 progression (CD4 count and HIV viral load). There was a trend towards an association between treatment for Schistosoma mansoni and a decrease in HIV viral load (Weighted mean difference (WMD)=-0·10; 95% Confidence interval (CI): -0·24, 0·03), although this association was not seen for Ascaris lumbricoides, hookworm or Trichuris trichiura. Treatment of A. lumbricoides, S. mansoni, hookworm or T. trichiura was not associated with a change in CD4 count. While pooled data from randomized trials suggested clinical benefit of de-worming for individual helminth species, these effects decreased when observational data were included in the pooled analysis. While further trials are needed to confirm the role of anthelmintic treatment in HIV-1 co-infected individuals, providing anthelmintics to individuals with HIV-1 may be a safe, inexpensive and practical intervention to slow progression of HIV-1.
在撒哈拉以南非洲，估计有超过 2200 万人同时感染了蠕虫和 HIV-1。有几项研究表明，对 HIV-1 感染者进行驱虫治疗可能会延缓 HIV-1 疾病的进展，而且驱虫的益处可能因个体感染的蠕虫种类而异。我们对已发表的文献进行了系统评价和荟萃分析，以确定治疗个体蠕虫感染对 HIV-1 进展标志物（CD4 计数和 HIV 病毒载量）的影响。针对曼氏血吸虫的治疗与 HIV 病毒载量降低之间存在关联趋势（加权均数差（WMD）=-0·10；95%置信区间（CI）：-0·24，0·03），但这种关联在蛔虫、钩虫或鞭虫中并未见到。针对蛔虫、曼氏血吸虫、钩虫或鞭虫的治疗与 CD4 计数的变化无关。虽然随机试验的汇总数据表明针对个别蠕虫种类进行驱虫治疗具有临床益处，但当将观察性数据纳入汇总分析时，这些效果会降低。虽然需要进一步的试验来证实驱虫治疗在 HIV-1 合并感染者中的作用，但为 HIV-1 感染者提供驱虫药可能是一种安全、廉价且实用的干预措施，可以减缓 HIV-1 的进展。
