HIV+/AIDS patients and parastic coinfections: the impact on their clinical progression and their implications for antiparasitic treatment and antiviral therapy

Abstract

The study investigated the possible enhancing or retarding effects that HIV and parasites can have on each other in a co-infection scenario. The changes to each other's pathogeneses were analysed along with the resulting changes in the patient's viral and parasitic loads. In conjunction with the patient's clinical manifestations, changes in the patient's cellular and immunological parameters were also highlighted. Considering their burden on global healthcare and their sufficiently documented relations with HIV and AIDS, the parasites included in this study were Plasmodium spp., Toxoplasma gondii, Leishmania spp., Cryptosporidium spp., Giardia lamblia, Wuchereria bancrofti, Schistosoma spp., Entamoeba histolytica, and Trypanosoma cruzi. All the aforementioned, apart from the latter two, appeared to assist HIV through different means by amplifying and enhancing its transcription and replication processes, with the two exceptions having conflicting or ambiguous findings. When looking at how HIV and AIDS affected these parasitic infections, a majority of them went on to progress to more severe and disseminated forms of disease given the patient's immunocompromised state due to HIV infection. In addition to this, it was also found that there was a greater propensity for certain latent parasitic infections to become activated. However, studies regarding coinfected individuals with Wuchereria bancrofti or Schistosoma spp. yielded different results, as no significant worsening of the parasitic disease was observed; only atypical manifestations were noted. The studies assessing the simultaneous administration of antiretroviral therapy and antiparasitic treatment uncovered the following effects: increased therapeutic effects, possible toxicity, exacerbation of adverse effects, or complete lack of interaction.