Adediran M. B.¹

¹Department of Integrated Science, Adeyemi Federal University of Education, Ondo, Nigeria

*Corresponding Author Email:adediranmoras@gmail.com

Abstract

Parasitic infections and HIV remain significant global health concerns, disproportionately affecting low- and middle-income countries. Parasitic diseases, such as malaria, schistosomiasis and leishmaniasis, contribute to high morbidity and mortality—particularly in tropical regions—due to poor sanitation, inadequate healthcare access and environmental factors. Similarly, HIV continues to be a leading cause of death globally, with over 38 million individuals living with the virus. Its immunosuppressive nature exacerbates the burden of co-infections, including parasitic diseases, thereby creating a complex public health challenge. Addressing these infections demands innovative solutions in diagnosis and management. Conventional diagnostic tools are often limited by sensitivity, accessibility and cost, while treatment options face challenges such as drug resistance and poor distribution. Recent advancements in biotechnology have paved the way for enhanced diagnostics, innovative therapeutics and vaccine development in the combat against various infectious diseases. These advancements offer promising pathways to revolutionise diagnostics and therapeutics, providing scalable, cost-effective and precise solutions for tackling these intertwined health threats. This review aims to highlight the transformative role of biotechnology in combating parasitic infections and HIV co-infection, identifying opportunities for future research and implementation to improve health outcomes worldwide.

Keywords: Parasitic infections, HIV co-infections, treatment, diagnostic tools, biotechnology.

1. Introduction

Parasitic infections such as malaria, schistosomiasis, lymphatic filariasis and human immunodeficiency virus (HIV) are diseases of public health concern (Slater et al., 2013). According to the World Health Organization (WHO), millions of people are affected by these infections, potentially increasing morbidity and mortality. Approximately 38.4 million people globally are living with HIV, with 1.5 million newly infected individuals, according to the World Health Organization report in 2022 (Moyo et al., 2023). Sub-Saharan Africa, in particular, accounts for about 70% of all the people living with HIV (Kharsany & Karim, 2016). In the same vein, parasitic infections such as malaria, lymphatic filariasis and schistosomiasis affect hundreds of millions of people worldwide, primarily in tropical and subtropical regions (Verjee, 2019). The WHO reported 241 million cases of malaria resulting in 627,000 deaths in 2020. The report also shows that 50 million people were infected with filariasis and 240 million were infected with schistosomiasis in the same year.

Co-infections with parasitic infections and HIV pose significant public health challenges globally, particularly in resource-limited settings and in regions with overlapping high prevalence, such as sub-Saharan Africa (Nissapatorn & Sawangjaroen, 2011). Parasites exacerbate HIV progression by compromising immune responses, while HIV increases susceptibility to severe parasitic complications. This bidirectional relationship contributes to heightened morbidity and mortality with a profound socioeconomic impact, perpetuating cycles of poverty as affected populations often face reduced productivity, financial strain from healthcare costs and limited access to effective care. These infections interact synergistically, often worsening disease outcomes, accelerating HIV progression and increasing the risk of treatment complications (Alemu et al., 2013). Individuals co-infected with HIV and parasites often experience accelerated disease progression, increased transmission rates and reduced responsiveness to antiretroviral therapy (Udeh et al., 2019).

Traditional diagnostic methods for parasitic infections, such as microscopy and serology, have limitations in terms of sensitivity and turnaround time (Ndao, 2009; Fearon, 2005). Moreover, the management of parasitic infections and HIV co-infections often involves complex treatment regimens, which can lead to drug resistance, toxicity and poor adherence (Nissapatorn & Sawangjaroen, 2011). Recent advances in biotechnology have revolutionised the diagnosis and management of parasitic infections and HIV co-infections (Zulfiqar et al., 2017). The development of novel molecular diagnostic tools, such as polymerase chain reaction (PCR) and next-generation sequencing (NGS), has improved the accuracy and speed of diagnosis. Additionally, biotechnological approaches—including recombinant protein expression, RNA interference (RNAi) and gene editing—have enabled the development of innovative therapeutics and vaccines (Traber & Yu, 2023). This study aims to provide an overview of the current biotechnological advances in the diagnosis and management of parasitic infections and HIV co-infections. It explores the latest molecular diagnostic tools, novel therapeutic approaches and emerging technologies, highlighting their potential to improve patient outcomes and control the spread of disease. In doing so, it seeks to contribute to the development of more effective and sustainable solutions for the diagnosis and treatment of parasitic infections and HIV co-infections, ultimately improving global public health outcomes by exploring the intersection of biotechnology and infectious disease management.

2. Infections and HIV Co-Infection

Parasitic infections, such as malaria, toxoplasmosis and cryptosporidiosis, are common and severe in HIV patients due to their weakened immune systems (Nissapatorn & Sawangjaroen, 2011). Effective management requires timely diagnosis, integrated treatment approaches and preventive strategies, including antiretroviral therapy (ART) to restore immune function (Bouabida et al., 2023). Biotechnological innovations offer hope for improved diagnostic and therapeutic solutions, especially in resource-limited settings. Parasitic infections are prevalent among HIV patients due to their compromised immune systems, particularly when CD4⁺ T-cell counts decline. These infections often result in more severe symptoms, atypical presentations and treatment complications compared with immune-competent individuals (Nsagha et al., 2016).

2.1 Common Parasitic Infections in HIV Patients

2.1.1 Malaria

Malaria is a leading parasitic infection in regions with high HIV prevalence, such as sub-Saharan Africa. HIV-infected individuals are at higher risk of severe malaria, recurrent infections and complications, especially when CD4 counts are low (Kwenti et al., 2018). HIV-induced immunosuppression impairs the body’s ability to control Plasmodium infection. Co-infection can lead to higher parasitaemia and treatment failure due to drug resistance. Severe anaemia, cerebral malaria and multi-organ dysfunction are more common in co-infected patients. Drug interactions between antimalarials and ART further complicate treatment (Obase et al., 2023).

2.1.2 Toxoplasmosis

Toxoplasmosis, caused by Toxoplasma gondii, is a major opportunistic infection in HIV patients, especially those with CD4 counts below 100 cells/µL. Reactivation of laten infection is common in HIV-positive individuals (Ayoade & Joel, 2022). The parasite invades tissues, particularly the brain, causing toxoplasmic encephalitis (TE). Co-infection worsens cognitive impairment and neurological symptoms (Elsheikha et al., 2020). Symptoms include headaches, fever, confusion, seizures and focal neurological deficits. Without treatment, toxoplasmosis is often fatal. Treatment includes pyrimethamine and sulphadiazine; however, adverse effects and drug availability in low-resource settings remain issues (Dunay et al., 2018).

2.1.3 Cryptosporidiosis

Cryptosporidium species cause cryptosporidiosis, a parasitic diarrhoeal disease particularly severe in HIV-infected individuals. It is prevalent in areas with poor sanitation and water quality. The parasite infects the intestinal epithelium, leading to persistent, watery diarrhoea and malabsorption. Severe dehydration and wasting are common in advanced HIV stages. Chronic diarrhoea, abdominal cramps, weight loss and fatigue are hallmark symptoms (Ahmadpour et al., 2020). Cryptosporidiosis is notoriously difficult to treat in HIV patients. Nitazoxanide is used but is less effective in immunocompromised individuals; ART improves immune function, reducing symptom severity and recurrence (Sparks et al., 2015).

Other notable parasitic infections include leishmaniasis, strongyloidiasis and microsporidiosis. Leishmaniasis causes severe visceral disease in HIV patients, characterised by fever, hepatosplenomegaly and pancytopenia. Strongyloidiasis is associated with hyperinfection syndrome, leading to widespread organ involvement and septicaemia in immunosuppressed individuals. Microsporidiosis often presents with chronic diarrhoea and malabsorption, contributing to wasting syndrome in advanced HIV (Nissapatorn & Sawangjaroen, 2011).

3. Epidemiological Hotspots and Vulnerable Populations

The co-infection of HIV and parasitic diseases is concentrated in specific geographical regions, particularly in low- and middle-income countries where both conditions overlap due to environmental, socioeconomic and healthcare-related factors (Alene et al., 2022). These epidemiological hotspots and vulnerable populations face heightened health challenges, including severe disease progression, limited healthcare access and economic instability. Understanding these dynamics is essential for developing targeted interventions that reduce the impact of HIV–parasitic co-infections, particularly in resource-constrained regions. Collaborative global efforts, supported by technological innovations, are key to alleviating the health and socioeconomic challenges faced by these populations (Jin et al., 2021). Sub-Saharan Africa accounts for over 65% of global HIV cases, with countries such as South Africa, Nigeria and Kenya bearing the highest burdens (Moyo et al., 2023). Moreover, malaria, schistosomiasis and helminthiasis are endemic owing to tropical climates, poor sanitation and vector abundance. Co-infection rates are therefore significant, with malaria–HIV co-infection being particularly prominent in areas with seasonal or year-round malaria transmission (Yapi et al., 2014). Although lower in South Asia, India and neighbouring countries account for the highest absolute number of HIV cases in Asia. Parasitic diseases prevalent there include visceral leishmaniasis (kala-azar), lymphatic filariasis and amoebiasis (Mathur et al., 2006). In Latin America, high HIV prevalence is concentrated in specific regions such as the Caribbean and parts of Brazil, with common parasitic diseases including Chagas disease (caused by Trypanosoma cruzi) and toxoplasmosis, which often lead to severe complications in HIV-positive individuals (Stauffert et al., 2017). HIV and malaria co-infections are widespread in the endemic zones of Myanmar, Thailand and Papua New Guinea in Southeast Asia and the Western Pacific. Poor sanitation and water quality make diarrhoeal parasitic infections (cryptosporidiosis) prevalent among HIV patients (Rattanapunya et al., 2015). Socioeconomically disadvantaged groups with limited access to healthcare, education and clean water form the majority of the vulnerable populations for HIV infections. Gender inequality and higher rates of sexual violence further increase women’s vulnerability to HIV (Igulot & Magadi, 2018). Pregnant women with HIV face additional risks of malaria and toxoplasmosis, leading to adverse maternal and neonatal outcomes. In children, co-infections during childhood lead to developmental delays, stunted growth and high mortality, especially in resource-poor settings (Jaén-Sánchez et al., 2023). Migrants, people in conflict zones, displaced populations and refugees face overcrowded conditions, poor nutrition and limited healthcare access, making them highly susceptible to co-infections (Daynes, 2016). Cross-border transmission also occurs through migratory flows, which spread infections across geographical regions, further complicating control efforts. Advanced HIV patients with low CD4⁺ T-cell counts are particularly prone to severe manifestations of parasitic infections (Chang et al., 2013). Other immunosuppressed conditions, such as malnutrition or organ transplantation, can amplify vulnerability.

Factors contributing to hotspots and vulnerability include environmental conditions—such as warm climates and high humidity supporting vector populations (especially mosquitoes and sandflies) responsible for malaria, leishmaniasis and other parasitic diseases (Bardosh et al., 2017)—inadequate access to antiretroviral therapy (ART), diagnostics and preventive measures, and cultural and behavioural practices such as unprotected sex, unsafe water use and reliance on traditional healing methods (Ren et al., 2019). Furthermore, conflict and weak governance, often stemming from political instability, hinder disease control efforts and further weaken healthcare infrastructure (Madhav, 2017).

Strategies to address hotspots and vulnerable populations include:

Policy and Funding: Strengthened global and national policies focused on healthcare equity, improved sanitation and poverty alleviation (De Foo et al., 2023).

Integrated Health Programmes: Combining HIV care with parasitic disease control initiatives can optimise resource use and improve health outcomes (Hoang et al., 2009).

Community-Based Interventions: Educating and empowering local communities to adopt preventive measures, such as insecticide-treated bed nets, water purification and safe sexual practices (Eskenazi et al., 2019).

Improved Diagnostics and Treatment: Accessible biotechnological tools and affordable therapies tailored for resource-limited settings can reduce morbidity and mortality (Ofori et al., 2024).

4. Pathophysiology of Co-Infection: Immune Interactions and Disease Progression

The co-infection of HIV with parasitic diseases creates a complex interplay between the pathogens and the host immune system, exacerbating disease severity and progression (Chang et al., 2013). This interaction is shaped by immune dysregulation caused by HIV and the immunomodulatory effects of parasites, leading to heightened susceptibility, faster disease progression and increased morbidity (Hochman & Kim, 2012).

4.1 Immune Dysfunction in HIV

HIV progressively depletes CD4⁺ T-cells—the central regulators of adaptive immunity—and disrupts immune homeostasis. A major dysfunction is the loss of CD4⁺ T-cells, which reduces immune surveillance and the ability to mount effective responses against opportunistic infections, including parasitic diseases (Vidya Vijayan et al., 2017). Chronic immune activation is another dysfunction, whereby persistent stimulation by HIV and parasitic antigens leads to immune exhaustion, thereby impeding pathogen clearance. Innate immunity may also be impaired, as HIV alters macrophage and dendritic cell functions, compromising antigen presentation and cytokine production that are critical for parasite control.

4.2 Parasitic Immunomodulation

Parasitic infections further exacerbate immune dysregulation through mechanisms such as:

• Immune Evasion: Parasites like Plasmodium and Toxoplasma gondii downregulate major histocompatibility complex (MHC) molecules and produce immunosuppressive factors, thereby limiting T-cell responses (Deroost et al., 2016).
• Th1/Th2 Imbalance: Parasitic infections may shift immune responses towards a Th2-dominated profile, thereby suppressing the Th1 responses necessary for HIV control. Parasites may also trigger excessive cytokine release (e.g. interleukin-10, transforming growth factor-β), which dampens pro-inflammatory responses and facilitates both parasite survival and HIV replication (Bretscher, 2014).

Treatment and management with highly active antiretroviral therapy (ART) partially restores immune function, reducing susceptibility to parasitic infections and improving co-infection treatment outcomes (Eggleton & Nagalli, 2023). However, targeted treatment for both parasites and HIV, alongside supportive care, is essential for mitigating immune dysfunction and improving quality of life. Biotechnological tools, such as immunomodulatory therapies and advanced diagnostics, offer promise in managing co-infections more effectively (Ramamurthy et al., 2020).

4. Revolutionary Impacts of Biotechnology

Addressing co-infections of human parasites and HIV requires integrated approaches, and recent biotechnological advancements offer innovative opportunities to improve diagnostic and treatment strategies in resource-limited settings. Biotechnology has become critical in addressing these complex co-infections, offering new solutions for improved diagnostics, treatment and prevention. Biotechnological advancements hold transformative potential in managing HIV and parasitic co-infections by addressing gaps in diagnostics, therapeutics and surveillance (Imran et al., 2017). As these innovations continue to evolve, integrating them into public health systems—particularly in endemic regions—is critical for reducing the burden of co-infections and improving patient outcomes globally (Zhou et al., 2021). Biotechnology has revolutionised healthcare in the following areas:

4.1 Diagnostics

• Point-of-Care (POC) Testing: Portable diagnostic kits, such as lateral flow assays and nucleic acid-based platforms (e.g. polymerase chain reaction [PCR] and Clustered Regularly Interspaced Short Palindromic Repeats [CRISPR-Cas systems]), allow early detection in remote settings (Kostyusheva et al., 2022). Multiplex tests that simultaneously screen for HIV and common parasitic co-infections reduce diagnostic delays and healthcare costs.
• Next-Generation Sequencing (NGS): This technology aids in identifying co-infections by detecting pathogens at the genomic level, enabling accurate characterisation of parasite species and their resistance profiles (Nafea et al., 2024).

4.2 Innovative Therapeutics

Biotechnologically engineered drugs targeting HIV and specific parasites simultaneously are emerging as effective interventions. Such combination therapies reduce pill burdens and minimise treatment failure due to drug interactions (Navasardyan et al., 2024). Other advances include:

• Biopharmaceuticals: Monoclonal antibodies and recombinant proteins have shown promise in treating parasitic infections and reducing their immunomodulatory effects that exacerbate HIV progression (Lu et al., 2020).
• Nanotechnology: Nanoformulations improve drug delivery by targeting infected cells with precision, minimising side effects and overcoming drug resistance challenges (Georgakopoulou et al., 2024).

4.3 Vaccine Development

Biotechnology has facilitated vaccine development for both HIV and parasitic infections, which is essential for long-term control (Tatoud et al., 2024). For example, mRNA-based platforms are being explored for their ability to stimulate robust immune responses, offering hope for effective HIV immunisation. Advances in recombinant DNA technology and adjuvant systems have led to promising vaccine candidates for malaria, leishmaniasis and schistosomiasis. Combined vaccination strategies may reduce the burden of co-infections.

4.4 Surveillance and Monitoring

Biotechnological tools also improve epidemiological surveillance and monitoring of co-infections through:

Biomarker Discovery: Advanced proteomics and metabolomics help identify biomarkers for co-infection severity, aiding in patient stratification and personalised care (Tambo et al., 2014).

Digital Health and AI Integration: Big data analytics and artificial intelligence (AI) facilitate the analysis of co-infection patterns, enhancing targeted intervention strategies.

5. Biotechnological Advances in Diagnosis

Advances such as molecular diagnostics, point-of-care tools, immunodiagnostics and nanotechnology have revolutionised the detection of HIV and parasitic co-infections (Lifson et al., 2016). These innovations improve diagnostic accuracy, accessibility and timeliness, thereby paving the way for better disease management and control, particularly in endemic regions with limited healthcare resources. Continued investment in these technologies is essential to ensure their affordability and widespread adoption.

For example, molecular diagnostics, such as PCR‐based methods, enable the early and accurate detection of pathogen DNA or RNA. PCR can detect Plasmodium spp. in malaria or Toxoplasma gondii DNA alongside HIV, even at low pathogen loads, making it useful for detecting latent or chronic parasitic infections that are difficult to identify through traditional methods. However, PCR requires laboratory infrastructure and trained personnel, which may be challenging in low-resource settings.

Advances in next-generation sequencing (NGS) allow high-throughput sequencing of entire genomes or metagenomes, enabling comprehensive identification of pathogens. This technology is applied in the simultaneous detection and differentiation of HIV strains and multiple parasitic species in co-infections, as well as in the identification of drug resistance markers for better treatment planning.

5.1 Point-of-Care Diagnostics

The Development of Rapid Diagnostic tests (RDTs) for co-infection provides results within minutes, often using minimal resources. For instance, malaria–HIV co-detection kits and antigen tests for Cryptosporidium and Toxoplasma gondii are useful in regions with high disease overlap (McMorrow et al., 2011). Such tests require minimal training for healthcare workers, are cost-effective and suitable for field settings. Furthermore, the integration of multiplex diagnostic tools, which combine multiple assays into a single test, can detect several pathogens simultaneously. Platforms such as the BioFire FilmArray or Cepheid GeneXpert can detect HIV, Plasmodium and other parasitic infections in a single run, thereby saving time and reducing the burden on laboratory resources.

5.2 Immunodiagnostics

Enzyme-linked immunosorbent assay (ELISA) tests are used to detect antibodies or antigens in patient samples. These tests can be applied for the combined detection of HIV antibodies and antigens of Toxoplasma gondii or Cryptosporidium (Alhajj et al., 2023) and have high sensitivity for detecting active infections. Lateral flow assays (LFAs) are portable, user-friendly and based on immunochromatographic principles; they are useful in the rapid diagnosis of malaria or HIV in remote settings and are low-cost and disposable.

5.3 Nanotechnology in Diagnostics

Nanoparticle-based biosensors enhance diagnostic sensitivity and specificity by improving signal detection. Examples include gold nanoparticles for detecting HIV RNA or Plasmodium antigens and quantum dots for multiplexed detection of co-infections. Nanostructures incorporated into advanced diagnostic platforms can miniaturise complex processes into portable devices, enabling the simultaneous detection of HIV, malaria and other parasitic infections from a single drop of blood (Thwala et al., 2023). These innovations reduce sample and reagent requirements and are ideally suited for deployment in resource-constrained areas.

6. Advances in Therapeutic Management

Innovations in pharmacology, biologics, gene editing and drug delivery systems offer improved treatment options for managing HIV and parasitic co-infections (Nelson et al., 2015). These advances address challenges such as drug resistance, treatment adherence and the complexity of co-infections, particularly in vulnerable populations. Continued research and investment are essential to translate these innovations into practical, accessible solutions for resource-constrained regions.

6.1 Pharmacological Developments

1. Antiretroviral Therapy (ART) and Its Interaction with Antiparasitic Drugs: ART remains the cornerstone of HIV treatment, significantly improving immune function and reducing viral load (Günthard et al., 2016). However, in co-infected patients, ART can interact with antiparasitic drugs through shared metabolic pathways (e.g. cytochrome P450 enzymes), affecting drug efficacy and increasing toxicity risks. For instance, protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) may interact with antiparasitic drugs such as artemisinin derivatives and azoles (Kiang et al., 2014). New drug formulations and combination therapies targeting co-infections—such as the co-administration of trimethoprim-sulphamethoxazole for Toxoplasma gondii prophylaxis or the combination of dolutegravir with artemether-lumefantrine for HIV–malaria co-infections—have the potential to reduce pill burden and improve treatment outcomes while lowering the risk of drug resistance.
2. Biologics and Immunotherapy: The use of monoclonal antibodies for parasitic infections in immunocompromised patients targets specific antigens on parasites or host cells, offering high specificity and reduced systemic toxicity compared with traditional drugs (Longoni et al., 2021). These therapies also have the potential to neutralise resistant parasite strains. Vaccine development targeting parasites such as Plasmodium, Toxoplasma gondii or Cryptosporidium could significantly reduce the co-infection burden in HIV patients. For example, the RTS,S/AS01 (Mosquirix) malaria vaccine holds promise for deployment in regions with high HIV prevalence. Experimental vaccines for leishmaniasis and toxoplasmosis are also in preclinical and clinical trials.
3. Gene Editing and CRISPR Technology: Gene editing is being explored for both host and pathogen modification to improve disease management (Hawsawi et al., 2022). For host gene editing, CRISPR-Cas9 technology is being used to modify immune genes (such as CCR5) to render cells resistant to HIV infection and potentially enhance immune responses against parasitic infections by modulating cytokine profiles or T-cell function (Binnie et al., 2021). For pathogen gene editing, CRISPR tools can target and disrupt essential parasite genes involved in invasion or immune evasion (Di Cristina & Carruthers, 2018), and may also be applied to modify parasite vectors (e.g. mosquitoes) to block transmission.
4. Drug Delivery Innovations: Nanoparticles—including liposomes, polymeric nanoparticles and dendrimers—can improve drug delivery by enhancing bioavailability, targeting and controlled release (Begines et al., 2020). For example, liposomal amphotericin B is used for visceral leishmaniasis in HIV patients, reducing toxicity and improving efficacy. Such nanocarriers can co-deliver ART and antiparasitic drugs, reducing systemic side effects and enhancing drug penetration into parasitised tissues. Nanoparticles functionalised with ligands or antibodies for site-specific delivery have been developed, such as transferrin-conjugated nanoparticles for brain delivery in toxoplasmosis. Sustained-release formulations can reduce dosing frequency and improve adherence, which is particularly important in resource-limited settings.

7. Biotechnological Contributions to Prevention

Biotechnology has made significant strides in preventing parasitic infections and HIV co-infections by addressing challenges such as pathogen transmission, immune suppression and global health inequities (Imran et al., 2017). Genetically modified organisms (GMOs), for instance, include sterile male Anopheles mosquitoes produced using CRISPR-Cas9 techniques, which disrupt reproduction and reduce vector populations (Garrood et al., 2022). Gene drives engineered to spread genetic traits that prevent mosquitoes from transmitting Plasmodium can reduce malaria transmission in regions with high HIV–malaria co-infection rates and decrease reliance on chemical insecticides, thus reducing environmental harm.

Public health biotechnology also plays a major role in surveillance and epidemiological monitoring through molecular surveillance tools such as NGS, which identify hotspots of co-infections and emerging drug-resistant strains. Geographic information systems (GIS) combined with biotechnological data aid in mapping disease spread and improving targeted interventions (Chandran & Roy, 2024). Innovative preventive strategies include the development of long-acting prophylactic drugs and biosensors that detect parasitic contaminants in water and food, thereby preventing infections like cryptosporidiosis. Community-level interventions, such as public health campaigns that promote hygiene, vector control and vaccination, are also crucial.

8. Challenges and Opportunities in Biotechnological Applications

8.1 Diagnostic Challenges

Despite significant improvements, challenges remain in the application of biotechnological advancements in low-resource settings:

• High Costs: Advanced diagnostic tools, such as NGS and multiplex PCR assays, remain expensive and often unaffordable in many low-income regions.
• Limited Infrastructure: Many rural and resource-limited areas lack the necessary laboratory facilities and trained personnel to implement sophisticated biotechnological diagnostic methods (Heidt et al., 2020).
• Scalability Issues: Technologies that work well in research or high-income settings may not be easily adapted for widespread use in endemic regions due to logistical barriers such as unstable electricity supply and the lack of cold-chain storage for reagents (Boro & Stoll, 2022).
• Access to Testing: Remote communities often experience delays in obtaining diagnostic results, making timely treatment difficult.

8.2 Therapeutic Limitations

• Emergence of Drug Resistance: Increasing resistance of parasites (e.g. Plasmodium falciparum in malaria) and HIV to existing drugs is a major concern. Some parasites have developed resistance to antimalarials (e.g. artemisinin resistance in Southeast Asia), while HIV has developed resistance to first-line ART in some settings (Menard & Dondorp, 2017).
• Drug-Drug Interactions: Managing parasitic infections in HIV-positive individuals is complicated by potential adverse interactions between antiparasitic drugs and ART. For example, rifampicin (used for tuberculosis) may reduce the effectiveness of some antiretroviral drugs, requiring careful selection of treatment regimens (Semvua et al., 2015).
• Toxicity Concerns: Many antiparasitic and antiretroviral drugs cause significant side effects, such as hepatotoxicity and nephrotoxicity, which can limit long-term use.

8.3 Regulatory and Ethical Considerations

• Regulatory Delays: The development and approval of new biotechnological interventions, such as gene editing (CRISPR) for HIV cure strategies and genetically engineered vaccines for parasitic infections, often face prolonged regulatory processes, which slow their deployment (Hussein et al., 2023).
• Ethical Concerns: Gene-based therapies raise ethical issues regarding unintended genetic modifications, long-term safety and equitable access (Joseph et al., 2022).
• Vaccine Trials: Conducting vaccine trials for parasitic infections and HIV in endemic areas requires careful ethical considerations, including informed consent and the fair distribution of benefits (Dawson et al., 2015).
• Data Privacy: The use of genomic data in personalised medicine and AI-driven diagnostics raises concerns about data security and the potential misuse of genetic information (Bonomi et al., 2020).

Future Opportunities

Despite these challenges, biotechnological advances hold great promise for improving the diagnosis and management of parasitic infections and HIV co-infection. Overcoming cost barriers, improving accessibility and addressing regulatory and ethical concerns will be crucial for successfully implementing these innovations. Future opportunities include:

• AI-Powered Diagnostics: Machine learning algorithms can analyse microscopic images, PCR results and genomic data to improve the speed and accuracy of detecting both parasites and HIV. AI-assisted tools, such as smartphone-based malaria diagnostics, offer promising solutions for remote settings (Alsulimani et al., 2024).
• Drug Discovery: AI-driven computational models can predict potential drug candidates and optimise drug combinations for HIV and parasitic infections, thereby reducing the time and cost of drug development.
• Host–Pathogen Interaction Studies: Advances in biotechnology enable the identification of genetic and immunological factors that influence an individual’s response to co-infections, paving the way for personalised treatment regimens.
• Pharmacogenomics: Tailoring ART and antiparasitic drug regimens based on a patient’s genetic profile can help optimise efficacy and minimise adverse drug reactions.
• Biological Therapies: Monoclonal antibodies and therapeutic vaccines offer potential in managing persistent parasitic infections and HIV, especially in immunocompromised individuals.

5. Conclusion

Biotechnological advancements have significantly improved the diagnosis and management of parasitic infections and HIV co-infection. Cutting-edge molecular techniques—including PCR-based assays, next-generation sequencing and CRISPR-based diagnostics—offer enhanced sensitivity and specificity for early detection. In therapeutics, biopharmaceutical innovations such as monoclonal antibodies, recombinant vaccines and gene-editing approaches show promise in addressing co-infections more effectively. Despite these advances, challenges remain, including high costs, limited accessibility in resource-constrained settings and the need for further clinical validation. Bridging these gaps through interdisciplinary research and equitable healthcare policies will be essential in maximising the benefits of biotechnology for global health.

Conflict of interest

There are no competing interests to disclose in relation to this study.

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APA
Adediran M. B. (2025). Biotechnological Advances in the Diagnosis and Management of Parasitic Infections and HIV Co-infection. In Akinyele B.J., Kayode R. & Akinsemolu A.A. (Eds.), Microbes, Mentorship, and Beyond: A Festschrift in Honour of Professor F.A. Akinyosoye. SustainE

Chicago
Adediran M. B. 2025. “Biotechnological Advances in the Diagnosis and Management of Parasitic Infections and HIV Co-infection.” In Microbes, Mentorship, and Beyond: A Festschrift in Honour of Professor F.A. Akinyosoye, edited by Akinyele B.J., Kayode R. and Akinsemolu A.A., SustainE.

Corresponding Author Email: adediranmoras@gmail.com

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