Prevalent Chronic Infections Modulate T-Cell Phenotypes and Functions Enhancing HIV Susceptibility, Dissemination, and Persistence in African Population

Abstract

While many studies have associated HIV prevalence with socio-economic status, few have explored the host's immunity status prior to HIV infection. High HIV prevalence in Africa may in part be contributed by a high prevalence of other persistent infections that modulate the host immunity towards phenotypes that promote HIV acquisition. In this narrative review, we examined how four most prevalent pathogens in Africa (human papillomavirus, herpesviruses, Mycobacterium tuberculosis, and helminth infections) modulate immunity to favor their survival and in turn, also influence HIV acquisition. We have described how these pathogens expand the number of memory and activated T cells, increase the expression of HIV entry receptors leading to an increased HIV susceptibility, and show how these pathogens' immunoevasive strategies may favor HIV persistence. A better understanding of the association between immunomodulation caused by other prevalent infections and HIV/AIDS prevalence may improve HIV/AIDS preventive strategies in Africa. We suggest intensifying efforts to control these chronic infections by making drugs or vaccines available in endemic regions. This may act as another indirect strategy to complement current HIV/AIDS interventions in Africa. We also call for more research to understand better the relationship between immunomodulation by other prevalent infections and HIV incidence.