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Years: 2021 – 2022

Training Site: UNC Project – Malawi

Country: Malawi

Mentors: Rojelio Mejia, MD; Mina Hosseinipour, MD, MPH

Title: “Impact of parasitic infections on intestinal epithelial barrier and immune-activation among persons living with HIV in Malawi”

Program Objectives: The overall goal of our research program is to determine if periodic deworming of persons living with HIV (PWH) in helminth-endemic regions will lead to decreased morbidity and mortality associated with HIV by reducing chronic inflammation associated with these diseases. Our hypothesis for this project is that helminthic infections contribute to a modifiable pro-inflammatory state in PWH.

Aim 1: Determine the prevalence of parasitic infections in PWH 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 parasitic infection in PWH in Malawi is common.

Aim 2: Determine the impact of parasitic infection and eradication on intestinal inflammation and immune activation by measuring soluble CD14 (sCD14), sCD163, and intestinal fatty acid binding protein (I-FABP) in PWH 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 compared with parasite negative participants with HIV, and these biomarkers decrease with anti-helminth treatment.

NIH Support: FIC-AIDS

Melissa Reimer-McAtee headshot