Researchers have found that a parasitic worm called schistosomiasis, which infects over 250 million people in developing nations, may be contributing to the spread of HIV. The worms can cause lesions when they lay eggs in women's genital areas, making women three times more likely to contract HIV. Treating the parasitic worm could help reduce HIV transmission, as the drug is inexpensive and donated by the WHO. Additionally, men infected with the worms had HIV viral loads in their semen 10 times higher than uninfected men, but levels returned to normal after treatment. Experts believe addressing this neglected risk factor could significantly help in fighting the HIV epidemic.

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Parasitic worms may hold key to cutting
spread of HIV: researchers
Thu Apr 28, 2016 12:13pm GMT
By Alex Whiting
LONDON (Thomson Reuters Foundation) - A parasitic worm which affects
millions of the world's poorest people may hold an important but little-known
key to cutting the spread of HIV, researchers said ahead of a conference on
the issue in London.
Schistosomiasis affects at least 250 million people. It is caused by parasitic
worms, picked up in infested waters, which drill through people's skin and lay
eggs in their bodies.
If the worms lay eggs in a woman's genital areas, including the vagina and
cervix, they can cause lesions which make women more vulnerable to HIV,
experts in the tropical disease said.
Women are three times more likely to be infected with HIV if they have
female genital schistosomiasis (FGS), studies carried out in Zimbabwe,
Tanzania, South Africa and Mozambique have found.
"It's going completely under the radar," Marianne Comparet, director of the
London-based International Society for Neglected Tropical Diseases
(ISNTD), said in an interview.
"Treating one could really impact on the other," she told the Thomson
Reuters Foundation.
Men with the worms in their genitals show a sharp increase in the amount of
HIV virus in their semen, researchers said.
The treatment for schistosomiasis is cheap - the drug has been donated for
years to the World Health Organization (WHO), so this could be a relatively
easy way to help cut the spread of HIV, experts said.
"In the same way that circumcision came out as something that really
changed the way people approached HIV transmission, this could really be
the next big thing in controlling HIV transmission," Comparet said.
Circumcision has been found to cut the spread of HIV among heterosexuals
and is recommended by the WHO as a means of prevention.
Nearly 37 million people live with HIV, the majority in Africa.
A LITTLE-KNOWN DISEASE
It is not known how many people have FGS, but estimates range from 20
million to 80 million, the vast majority in Africa.
According to the WHO, most cases of FGS are undiagnosed and few
medical staff are aware of its existence. It gets no mention in medical
textbooks or nursing curricula in any of the countries where schistosomiasis
is endemic, WHO says.
The U.N. agency recommends the regular treatment of young girls through
mass drug administration in schools and communities to prevent FGS from
developing.
Treatment kills adult worms but it cannot reverse damage they have already
done to people's organs and tissues.
"It starts early on, and then when you are a young woman, without any
treatment it becomes really serious, and when women become sexually
active they are very vulnerable to HIV," Jutta Reinhard-Rupp at Merck
Serono said in an interview.
Merck Serono produces praziquantel, the only treatment available for
schistosomiasis.
FGS can also cause other complications including infertility and ectopic
pregnancies.
The link between FGS and HIV is very difficult to prove in a clinical study
because it not possible to have a control group that is left untreated,
Reinhard-Rupp said.
Another possible link is between schistosomiasis in men's genitals and the
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2. spread of the HIV virus.
Men with both diseases had an HIV viral load in their semen 10 times bigger
than that of men without schistosomiasis, according to initial findings from a
small-scale study carried out in Zimbabwe last year.
After treatment for schistosomiasis, the viral load returned to normal levels.
The findings will be made public at the ISNTD Coinfections conference in
London on Friday.
Many countries in southern Africa are seriously affected by both
schistosomiasis and HIV, Peter Leutscher, who is a professor at Aarhus
University Hospital and helped carry out the research, said in a telephone
interview.
"This overlap of HIV and schistosomiasis is really striking," he told the
Thomson Reuters Foundation.
"It's a neglected risk factor" in the fight against HIV, he said.
Leutscher wants genital schistosomiasis to be included alongside other risks
involved in the spread of HIV like the number of sexual partners, condom
use, circumcision, and other sexually transmitted diseases.
(Reporting by Alex Whiting, editing by Tim Pearce.; Please credit the
Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that
covers humanitarian news, women's rights, trafficking, corruption and climate
change. Visit news.trust.org)
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