Dr Roxanne Pillay Studies Impact of Hookworm Co-Infection on Women’s Health

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Simple interventions, like regular adult deworming, could have far-reaching benefits for public health.

This is one of the key messages from Dr Roxanne Pillay’s PhD research in Medical Microbiology, which explored how hookworm infection influences herpes simplex virus type 2 (HSV-2), a common sexually transmitted viral infection, and the potential development of cervical cancer.

Soil-transmitted helminths (STHs), or parasitic worms such as hookworms, suppress the body’s immune system. This makes an infected person more susceptible to unrelated infections. There is already evidence demonstrating that STHs dampen host immune responses and increase susceptibility to sexually transmitted viral infections, such as HIV and Human Papillomavirus (HPV). However, the relationship between STHs and HSV-2 remains largely underexplored.

While there is no epidemiological or immunological data on hookworm and HSV-2 co-infections in humans, a landmark animal study has shown that prior hookworm infection worsens HSV-2 infection in the female genital tract (FGT). Using this model, Pillay investigated the molecular mechanisms underlying hookworm and HSV-2 co-infection in the FGT. Her research focused on how co-infection impacts microRNA (miRNA) and messenger RNA (mRNA) expression patterns, and how these changes may influence FGT immune responses and potentially contribute to the development of cervical cancer.

“This work is particularly relevant in Africa, where distribution of these pathogens overlaps, and co-infections are likely,” Pillay says. “Hookworm/HSV-2 co-infection may have important implications for female reproductive health. For example, we have shown that co-infection suppresses miRNA and mRNA expression profiles in ways that influence FGT immune responses and enrich cancer-related pathways.”

Pillay’s interest in medical laboratory science began in high school in Umzinto, KwaZulu-Natal. “I’ve always enjoyed the complexity of science,” she says. “Our work directly impacts patients’ lives through research that helps shape better treatment interventions. And for us, behind every blood sample is a patient - a human being whose life we are trying to improve. That makes our work very purposeful.”

Pillay has warm reciprocal relationships with her supervisors. “It’s been a privilege working with Professor Zilungile Mkhize-Kwitshana and Dr Pragalathan Naidoo,” she says. “They have been instrumental in my development as an academic and woman in research.”

Co-supervisor Naidoo said, “Roxanne was a pleasure to co-supervise. She is not only a dedicated and meticulous researcher but also a person of sterling character - respectful, receptive to guidance, and genuinely collaborative. Her research accolades are a direct reflection of her hard work, integrity, and scholarly excellence.”

Award-winning Mkhize-Kwitshana is equally enthusiastic: “Roxanne was one of my best students, and she has explored something significant. Studies of parasites in adults are neglected; they are seen as childhood conditions. But in Africa, worm infections are rife, and re-infection is common. Parasites suppress the immune system of the host; that renders the infected host not only more susceptible to chronic conditions like HIV, tuberculosis and cancer, but makes them harder to treat. Once the infection is in the intestinal tract, it affects all related systems, which is why Roxanne’s work is so important - it looks at how hookworms affect the female reproductive tract, which is largely under-studied.”

Words: Matthew Hattingh

Photograph: Sethu Dlamini