Summary of findings for the main comparison. Summary of findings for participants with unknown helminth infection status.
| Deworming drugs compared with placebo for people with HIV and an unknown helminth infection status | ||||
|
Participant or population: HIV‐positive people Settings: urban and rural areas co‐endemic for helminths and HIV Intervention: deworming drugs (albendazole or praziquantel or a combination) Comparison: placebo | ||||
| Outcomes | Illustrative comparative risks* (95% CI) | Number of participants (trials) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | |||
| Placebo | Deworming drugs | |||
| Viral load | At 6 weeks after a single dose | 166 (1 trial) |
⊕⊕⊝⊝1,2,3,4 low | |
| in the control group, the mean change in viral load was an increase of 0.09 log10 viral RNA |
On average, with deworming, there was a suppressive effect on mean viral load of 0.14 log10 viral RNA (0.35 benefit to 0.07 harm) |
|||
| At 2 years after multiple doses | 917 (1 trial) |
⊕⊕⊕⊝1,2,5,6 moderate | ||
| In the control group, the mean viral load increased by 0.03 log10 viral RNA |
On average, with deworming, there was a suppressive effect on mean viral load of 0.01 log10 viral RNA (0.03 benefit to 0.05 harm) |
|||
| CD4+ cell count | At 2 years after multiple doses | 917 (1 trial) |
⊕⊕⊝⊝1,2,4,5 low | |
| In the control group, the mean CD4+ cell count reduced by 37.3 CD4+ cells/µL |
On average, with deworming, there was a favourable effect on mean CD4+ cell count of 2.60 CD4+ cells/µL (15.35 benefit 10.15 harm) |
|||
| *The basis for the assumed risk (for example, the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). Abbreviations: CI: confidence interval; RR: risk ratio; RNA: ribonucleic acid; HIV: human immunodeficiency virus. | ||||
| GRADE Working Group grades of evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | ||||
1No serious risk of bias: this single trial was at low risk of selection bias. 2No serious inconsistency: this was not applicable as there was only a single trial. 3We downgraded by 1 for serious indirectness: this single trial is based upon a specific sample of pregnant women treated with albendazole or praziquantel, or both. The overall finding of an effect cannot be easily generalized to all populations or settings. 4We downgraded by 1 for imprecision: the 95% CI includes potentially clinically important differences as well as no effect. Further larger studies are needed. 5We downgraded by 1 for serious indirectness: this trial was conducted in three sites in rural and urban Kenya. Helminth infection was expected to be high but was not assessed at baseline. The findings are not easily generalized to all helminth endemic settings. 6No serious imprecision: the 95% CI includes no effect but is narrow around the estimate and excludes clinically important differences.