Schistosomiasis and HIV-1 Infection in Rural Zimbabwe: Implications of Coinfection for Excretion of Eggs

• Published in: The Journal of infectious diseases 2005-04, Vol.191 (8), p.1311-1320
• Main Authors: Kallestrup, Per, Zinyama, Rutendo, Gomo, Exnevia, Butterworth, Anthony E., van Dam, Govert J., Erikstrup, Christian, Ullum, Henrik
• Format: Article
• Language: English
• Subjects: Adult; Age Distribution; AIDS; Antigens; Biological and medical sciences; Body Mass Index; CD4 Lymphocyte Count; Cohort Studies; Cross sectional studies; Diseases caused by trematodes; Excretion; Female; Fundamental and applied biological sciences. Psychology; Helminthic diseases; HIV 1; HIV Infections - complications; HIV Infections - epidemiology; HIV Infections - immunology; HIV Infections - parasitology; HIV/AIDS; Human immunodeficiency virus 1; Human viral diseases; Humans; Infections; Infectious diseases; Male; Medical sciences; Microbiology; Miscellaneous; Parasite Egg Count; Parasites; Parasitic diseases; Physiological immunosuppression; Regression Analysis; Rural Health - statistics & numerical data; Schistosoma haematobium; Schistosoma mansoni; Schistosomiases; Schistosomiasis; Schistosomiasis - complications; Schistosomiasis - epidemiology; Schistosomiasis - parasitology; Schistosomiasis - urine; Urine; Urine - parasitology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Virology; Zimbabwe - epidemiology
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/428907

BackgroundStunted development and reduced fecundity of Schistosoma parasites in immunodeficient mice and the impaired ability of human immunodeficiency virus 1 (HIV-1)–infected humans to excrete schistosome eggs have been described. This study explores the effect that HIV-1–associated immunodeficiency has on the excretion of schistosome eggs in a large cohort of coinfected individuals MethodsIn a cross-sectional survey, urine and stool samples were obtained from and HIV-1 status was determined for 1545 individuals. More extensive data, including quantitative measures of intensity of infection in schistosomiasis and immunodeficiency, were collected in the Mupfure schistosomiasis and HIV longitudinal cohort, composed of 379 participants of whom 154 were coinfected with HIV-1 and Schistosoma parasites ResultsIn the cross-sectional survey, the overall prevalence of schistosomiasis was 43.4%, and 26.3% of the participants were infected with HIV-1. Schistosome infections were due to Schistosoma haematobium in 63.6% of cases, S. mansoni in 18.1% of cases, and dual infections in 18.4% of cases. Intensities of Schistosoma infections, measured by the number of eggs excreted and by the level of circulating anodic antigens, did not differ between HIV-1–negative and HIV-1–positive participants coinfected with S. haematobium, S. mansoni or both. CD4 cell counts were significantly lower in HIV-1–positive participants and in S. mansoni–infected HIV-1–negative participants than in other participants ConclusionThe present study suggests that adult HIV-1–related immunodeficiency does not impair the ability to excrete eggs in low-intensity infection with S. haematobium, S. mansoni or both and that infection with HIV-1 may not have major implications for diagnosis and surveillance of schistosomiasis