Conclusions
We have presented the results of the interaction between helminthic infection, HIV and tuberculosis, with a major emphasis on the immune changes accompanying helminthic infections and their implications for these interactions. The major common denominator to these interactions is the immune activation and the skewed cytokine profile which the helminthic infections cause and which markedly affects the ability of the host to cope with either HIV or tuberculosis. The most important conclusion that can be drawn at this stage, is that the suppression of helminthic infections, may have a major impact on the spread and progression of HIV infection and tuberculosis, as well as on the success of protective vaccines against both. This conclusion applies particularly to the developing countries, where all these infections are so common and where access to antiretroviral therapy is not available. It is however critical to show if suppression of helminthic infections leads to decreased incidence of HIV and tuberculosis, will it be accompanied by decreased HIV viral load and progression of the infection, and just as importantly, whether generation of protective immunity to HIV and tuberculosis will be improved after deworming. Since the public health case for deworming has already been demonstrated by its effectiveness in enhancing the development of children (see Chapters 3 and 4), large scale eradication of helminthic infections throughout the developing world in the context of the AIDS and tuberculosis epidemics, should be seriously considered and implemented, even if the consequences are only probable or partially positive.
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Borkow, G., Bentwich, Z. (2002). Geohelminths, HIV/AIDS and TB. In: Holland, C.V., Kennedy, M.W. (eds) The Geohelminths: Ascaris, Trichuris and Hookworm. World Class Parasites, vol 2. Springer, Boston, MA. https://doi.org/10.1007/0-306-47383-6_16
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