Immunological interaction during helminth and HIV co-infection: Integrative research needs for sub-Saharan Africa

Significance: Sub-Saharan Africa is heavily burdened with human immunodeficiency virus (HIV) and helminth infections, which are potent activators of pro-inflammatory and anti-inflammatory immune responses, respectively. Considering that helminths (such as Necator americanus, Ancylostoma duodenale, Ascaris lumbricoides, Trichuris trichiura, Schistosoma haematobium, and Schistosoma mansoni) can potentially dampen the production and expression of vital anti-viral pro-inflammatory cytokines, leading to enhanced HIV replication and severity, well-designed intervention studies are needed which will offer conclusive data on the nature of these interactions and the impact of deworming in HIV-infected patients. Such research will impact governmental health policies and deworming programmes, allowing for the implementation of integrated systems that will contribute to the overall improvement of African health systems.