There is wide geographic overlap in the occurrence of co-infections between worms and HIV, TB and malaria affecting tens of millions of people in both children and adults. Preliminary epidemiological data indicated that globally about 25% of individuals affected by HIV, malaria or worm infections were co-infected. Although worm infections and HIV, TB and malaria have been extensively investigated, only recently there has been increased attention to the potential impact of co-infections between worms and HIV, TB and malaria. Indeed, there is little information on the effects by worm infections on the HIV-, TB- and malaria-specific immune responses in humans, and little evidence as to whether such effects are detrimental, neutral or even beneficial. There is limited knowledge of the influence by underlying worm infections on the clinical course of HIV, TB and malaria. Finally, the impact by worm infections on vaccination requires further investigation as the very limited data available suggests reduced effectiveness of vaccines in subjects with worm infections.
IDEA will focus its efforts on four primary objectives:
- To determine the worm-induced modulation of the functional and molecular profile of HIV-, TB- and malaria-specific immune responses, in particular, how worm innate and adaptive immune responses instruct the subsequent development of HIV-, TB-, and malaria-specific immune responses
- To determine the impact by worm co-infections on measures of disease activity for HIV, TB and malaria. This investigation will allow us to understand better the interactions between different pathogens and their influence on disease activity
- To determine the immunologic markers of worm-, HIV-, TB- and malaria-specific immune responses associated with better control of pathogen replication and associated disease
- To determine the modulation by worm co-infections of vaccine-induced immune responses
IDEA will directly support the:
- Advancing of immunological understanding of what effect worm infections can have on altering immune responses (innate and adaptive) against HIV, TB and malaria
- Advancing of understanding of clinical outcome in worm/HIV, TB and malaria co-infections. Through combining the analysis of immunological outcome with clinical outcome IDEA will be able to link specific profiles to disease and subsequently obtain important information on what effect immune response alterations have on altering disease course
- Improving of immuno-modulatory drugs/intervention. IDEA will unravel what immune alterations are beneficial in co-infections and potentially decipher what will be good immune-modulatory compounds for use in augmenting or diminishing immune response against a number of infections. Furthermore, IDEA will be instrumental to complement the information as to whether de-worming programmes are beneficial for the health of communities with high burden of worms and malaria/HIV/TB. This question is yet unanswered, although WHO recommends regular de-worming to improve health in endemic countries
- Improving of vaccine design. IDEA will gain a better understanding of which immune responses need to be mounted (or not) in an effective vaccine against HIV, TB and malaria and whether the immune response is altered in the context co-infection with worms.