There is a growing body of evidence revealing the connection between neglected tropical diseases (NTDs) and HIV/AIDS, prompting experts to call for greater integration of national NTD treatment programs with HIV/AIDS initiatives.
Emerging evidence and treatment recommendations are the subject of a new editorial entitled "Linking Global HIV/AIDS Treatments with National Programs for the Control and Elimination of the Neglected Tropical Diseases," published this week in the open access journal Public Library of Science Neglected Tropical Diseases (PLoS NTDs). In the article, authors Julie Noblick, MPH; Richard Skolnik, MPA; and Peter Hotez, MD, PhD review the links between NTDs and HIV/AIDS and propose ways to take advantage of the accumulating evidence that shows how HIV/AIDS can be affected by NTDs.
Geographically, areas of high NTD infection are often the same areas that have high prevalence rates of HIV/AIDS. Studies from the past twenty years have shown different ways that HIV/AIDS can be exacerbated by various NTD co-infections. For example, recent studies have shown that deworming has an association with decreased HIV viral loads and/or elevations in CD4 counts, and also that maternal helminth infections increase the risk of maternal-to-child HIV/AIDS transmission. "We are particularly concerned about the associations between female genital schistosomiasis, a common condition in sub-Saharan Africa, and a 3-4 fold increased risk for HIV/AIDS," said Dr. Peter Hotez, President of the Sabin Vaccine Institute.
Based on the evidence, the authors of the paper call for a variety of actions aimed at fighting HIV/AIDS through control of NTDs. They advocate integration of the delivery of anti-retroviral drugs with NTD control and elimination programs; research to monitor and evaluate the success of NTD and HIV/AIDS cross-treatment; and the promotion of integrated control and implementation of new strategies.
While the article focuses on the benefits to HIV/AIDS treatment by NTD control, the authors believe that the proposed actions will help reduce overall NTD rates as well. "Integrating programmatic control measures for HIV/AIDS and NTDs would be a mutually beneficial course of action," Ms. Noblick said. "Not only could we expect improved health outcomes for people living with HIV/AIDS, but working with established global HIV/AIDS prevention and treatment programs also creates an opportunity to both increase the scale of NTD control operations and to elevate the level of attention paid to these traditionally neglected maladies."
Ms. Noblick also expressed hope for expansion of these latest strategies beyond national levels. "Since the initiation of NTD control measures would be based on careful prevalence mapping," she stated, "it would be fair to say that progress will emerge on the regional level as well. Treating NTDs should become standard practice in HIV/AIDS care."