TNF and coinfection: Co-infections with helminths such as schistosomiasis, soil-transmitted helminths and filarial infections (Wuchereria bancrofti, Onchocerca volvulus, Loa loa) have been linked to increased immune activation, and changes in cytokine profiles, including elevated IL-10 and TNF-α, which can exacerbate immune suppression and impact HIV disease progression (24, 25, 59).