Effect Modification of HIV-associated central nervous system Diseases by Parasitic Zoonoses in the Eastern Cape Province, South Africa

Objective: To estimate the cross-sectional associations between HIV and Taenia solium cysticercosis (CC) toxocariasis infections and to evaluate their interaction in clinically apparent neurological complications in the Eastern Cape Province, South Africa.

Methods: We are planning to enroll 300 patients under care in two academic hospitals. Patients will be selected according to their HIV status and by presence of neurological disorders. Serological presence of antigens and antibodies to CC and to antibodies to toxocarisis will be compared between groups. All HIV positive patients and all patients with neurological disorders will have recently had or be offered a brain CT-scan for the detection of neurocysticercosis or neurotoxocariasis.

Expected Results: We expect the sero-prevalence of antigens to CC to be highest in more advanced cases of HIV (untreated) followed by early stages HIV patients followed by HIV negative patients. The reverse tendency is expected of the sero-prevalence of toxocariasis and antibodies to CC. We hypothesize that there will be more lesions associated with NCC and toxocariasis among advanced stages HIV patients who do not have neurological manifestations as compared to advanced stages HIV patients with manifestations.

Discussion: Even though this project has not yet started, we should have some preliminary results to present in November. The long-term benefit of this research could improve the overall health of HIV patients living in endemic areas for neurocysticercosis and neurotoxocariasis through increased awareness among clinicians caring for those patients as well as among stakeholders and the development of prevention programs for parasitic zoonoses.