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Lancet Infect Dis. 2010 Jul;10(7):455-63. doi: 10.1016/S1473-3099(10)70093-1.

Effect of treating co-infections on HIV-1 viral load: a systematic review.

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  • 1Department of Medicine, Vanderbilt University School of Medicine, Medical Center, 2525 West End Avenue, Nashville, TN, USA. kayvon.modjarrad@vanderbilt.edu


Co-infections contribute to HIV-related pathogenesis and often increase viral load in HIV-infected people. We did a systematic review to assess the effect of treating key co-infections on plasma HIV-1-RNA concentrations in low-income countries. We identified 18 eligible studies for review: two on tuberculosis, two on malaria, six on helminths, and eight on sexually transmitted infections, excluding untreatable or non-pathogenic infections. Standardised mean plasma viral load decreased after the treatment of co-infecting pathogens in all 18 studies. The standardised mean HIV viral-load difference ranged from -0.04 log(10) copies per mL (95% CI -0.24 to 0.16) after syphilis treatment to -3.47 log(10) copies per mL (95% CI -3.78 to -3.16) after tuberculosis treatment. Of 14 studies with variance data available, 12 reported significant HIV viral-load differences before and after treatment. Although many of the viral-load reductions were 1.0 log(10) copies per mL or less, even small changes in plasma HIV-RNA concentrations have been shown to slow HIV progression and could translate into population-level benefits in lowering HIV transmission risk.

Copyright (c) 2010 Elsevier Ltd. All rights reserved.

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