Human hookworm infection enhances mycobacterial growth inhibition and associates with reduced risk of tuberculosis infection

Research output: Contribution to journalArticlepeer-review


  • Thomas E. Fletcher
  • Julius Muller
  • Rachel Tanner
  • Magali Matsumiya
  • J. Wendi Bailey
  • Jayne Jones
  • Steven G. Smith
  • Gavin Koh
  • Nicholas J. Beeching
  • James Dunbar
  • Duncan Wilson
  • Helen McShane

External organisations

  • Nuffield Department of Clinical Medicine
  • Queen Elizabeth Hospital Birmingham
  • Liverpool School of Tropical Medicine
  • London School of Hygiene and Tropical Medicine
  • Northwick Park Hospital
  • Institute of Infectious Disease and Molecular Medicine and Division of Immunology
  • University of Cape Town
  • Friarage Hospital


Soil-transmitted helminths and Mycobacterium tuberculosis frequently coincide geographically and it is hypothesized that gastrointestinal helminth infection may exacerbate tuberculosis (TB) disease by suppression of Th1 and Th17 responses. However, few studies have focused on latent TB infection (LTBI), which predominates globally. We performed a large observational study of healthy adults migrating from Nepal to the UK (n = 645). Individuals were screened for LTBI and gastrointestinal parasite infections. A significant negative association between hookworm and LTBI-positivity was seen (OR = 0.221; p = 0.039). Hookworm infection treatment did not affect LTBI conversions. Blood from individuals with hookworm had a significantly greater ability to control virulent mycobacterial growth in vitro than from those without, which was lost following hookworm treatment. There was a significant negative relationship between mycobacterial growth and eosinophil counts. Eosinophil-associated differential gene expression characterized the whole blood transcriptome of hookworm infection and correlated with improved mycobacterial control. These data provide a potential alternative explanation for the reduced prevalence of LTBI among individuals with hookworm infection, and possibly an anti-mycobacterial role for helminth-induced eosinophils.


Original languageEnglish
Article number2893
JournalFrontiers in immunology
Publication statusPublished - 14 Dec 2018


  • eosinophil, growth inhibition, hookworm, latent tuberculosis, LTBI, tuberculosis

ASJC Scopus subject areas