Conference Proceeding

Treatment of parasitic infection in HIV-1 co-infected patients decrease HIV plasma load

Dr. Hafiz Ahmad,
RAK College of Medical Sciences, United Arab Emirates

It is recognized that HIV progression to AIDS is facilitated by a chronic immuneactivation characterized by accelerated depletion of CD4+T cells and increase of viral load.

Dr. Hafiz Ahmad is an Assistant professor of Microbiology at RAK Medical and Health Sciences University, having a Ph.D in Medical Microbiology with over 10 years’ of teaching & research experience in Medical Molecular Microbiology particularly Infectious Diseases. Dr. Hafiz Ahmad is responsible for RAK Medical College’s undergraduate MBBS/BDS/Pharmacy/Nursing teaching and practical for around 500 students and spearhead the research lab. In my earlier capacity, he worked as a Doctoral Research Fellow at National Institute of Health, Bethesda, USA working with Dr. Leonid Margolis on Herpes infections and HIV transmission. He has contributed to 15 scientific international publications, 2 book chapters, 8 abstracts and 5 manuscripts in press review and have delivered several scientific presentations on Infectious diseases in particularly Opportunistic pathogenic interactions at various national & international conferences. He was awarded ICMR international travel grant for presenting my research work on HIV and parasitic infections of the gastrointestinal tract at Pathology 2013, USA. His recent work is on Evaluation of dried blood spot (DBS) as a method of sample collection for hepatitis C virus (HCV) RNA quantification is selected to be presented at Indian Association of Medical Microbiologists, MICROCON 2016 to be held at Postgraduate Institute of Medical Education and Research, Chandigarh – India. He also has the honor of serving as an Editorial Board Member for HIV Advance Research and Development and Jacobs Journal of HIV/AIDS, Texas, USA as well as a reviewer for Journal of AIDS and HIV Research.

Background: It is recognized that HIV progression to AIDS is facilitated by a chronic immuneactivation characterized by accelerated depletion of CD4+T cells and increase of viral load. Therefore, suppression of immuneactivation may have a major impact on the spread and progression of HIV infection. Parasitic infestations, known to cause chronic immuneactivation in the gut, are common in India. Here, we present the first study from India to investigate whether suppression of intestinal parasitic infection in HIV-1 coinfected patients lead to decrease in plasma load.
Material & Methods: Study population consisted of 378 HIV-1 patients presenting with diarrhea at AIIMS, New-Delhi. Parasites were detected in fecal samples using standard techniques. Viral load, CD4+Tcells were quantified and specific antiparasitic treatment (Co-trimoxazole, Nitazoxanide and Ivermectin) prescribed.
Results: The total parasite positivity was 38.3%. Amongst the intestinal protozoa, Isospora belli (19.6%) predominated the spectrum followed by Cryptosporidium (7.4%). Forty individuals infected with either Isospora belli, Cryptosporidium or Strongyloides stercoralis and without other co-infections were selected for a longitudinal follow-up of 3-4 weeks. Statistically significant decrease in plasma load was observed (p=0.0001) following successful antiparasitic treatment, with mean decrease of 0.46 log10. Although insignificant, there was an overall trend for immunological benefit with modest increase in CD4+Tcell count.
Conclusion: Hence, treatment of opportunistic intestinal parasites leads to decrease in plasma load. Observed results are in agreement with the studies performed in sub-Saharan Africa. The decrease of immune activation induced by suppression of parasitic infection may be the common cause of the decrease of plasma load in both studies.

Published: 05 May 2017