De-worming has a positive effect on CD4 count in pregnant women

13 October 2014
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Treating pregnant HIV-positive women who are on antiretroviral treatment (ART) for helminth infections, also known as worm infections, is proven to increase CD4 count and haemoglobin level and decrease viral HIV load. These findings are a result of a recently published study in Clinical Infectious Diseases, conducted in Rwanda.

Worm infections are a major problem in countries with high HIV prevalence rates. Co-infection of HIV and helmithes are estimated to affect 22 million people across sub-saharan Africa. As both malaria and worm infections are known to contribute to the progression of HIV, sufficient treatment is necessary. During pregnancy, co-infections increase the risk of anemia and mother-to-child HIV transmission increasing the need to treat co-infections in pregnant women.

In previous studies it is shown that helminth treatment reduces the HIV viral load, although there is little evidence regarding the benefits of de-worming in HIV-infected pregnant women receiving ART. The study included 980 women, who were divided into two groups, one group only receiving treatment after laboratory-confirmation of helminth infection, and the other group receiving treatment regardless of confirmation of helminth infection. Treatment of helminthes was proven to be effective in both confirmed and not confirmed infections. This suggests that in high epidemic helminthes regions, non-targeted anthelminthic therapy may be more cost effective than a test-then-treat procedure. The study shows that increases in CD4 count levels occur with the removal of helminths, and implies that treatment for helminths should be administered for all pregnant HIV positive women to benefit their health.

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