The overall goal of this study is to determine if periodic de-worming of persons living with
HIV in intestinal parasite-endemic regions will lead to decreased morbidity and mortality
associated with HIV by reducing immune activation and intestinal damage associated with these
diseases. The hypothesis for this project is that intestinal parasitic infections contribute
to a modifiable pro-inflammatory state in persons living with HIV (PLWH).
Aim 1: Determine the prevalence of intestinal parasitic infections in PLWH receiving care at
an HIV-treatment center in Lilongwe, Malawi using a highly sensitive multi-parallel stool PCR
test. Hypothesis: highly sensitive stool PCR testing will demonstrate that disease burden of
parasitic infection in PLWH in Malawi is higher than historically reported based on stool
microscopy.
Aim 2: Determine the impact of parasitic infection on intestinal damage and immune activation
by measuring sCD14, sCD163, and intestinal fatty acid binding protein (I-FABP) in PLWH.
Hypothesis: plasma biomarkers reflecting intestinal damage and immune activation are elevated
in those with HIV and parasitic co-infection compared with parasite-negative participants
with HIV.
Aim 3: Determine the impact of eradication of parasitic infection on intestinal damage and
immune activation by measuring sCD14, sCD163, and intestinal fatty acid binding protein
(I-FABP) in PLWH before and after treatment of parasitic co-infection. Hypothesis: plasma
biomarkers reflecting intestinal damage and immune activation are elevated in those with HIV
and parasitic co-infection, and these biomarkers decrease with anti-parasitic treatment.
Phase:
N/A
Details
Lead Sponsor:
University of North Carolina, Chapel Hill
Collaborator:
Fogarty International Center of the National Institute of Health