Helminth-Associated Systemic Immune Activation and HIV Co-receptor Expression: Response to Albendazole/Praziquantel Treatment

Abstract

BackgroundIt has been hypothesized that helminth infections increase HIV susceptibility by enhancing systemic immune activation and hence contribute to elevated HIV-1 transmission in sub-Saharan Africa.ObjectiveTo study systemic immune activation and HIV-1 co-receptor expression in relation to different helminth infections and in response to helminth treatment.MethodsHIV-negative adults with (n = 189) or without (n = 57) different helminth infections, as diagnosed by Kato-Katz, were enrolled in Mbeya, Tanzania. Blinded to helminth infection status, T cell differentiation (CD45RO, CD27), activation (HLA-DR, CD38) and CCR5 expression was determined at baseline and 3 months after Albendazole/Praziquantel treatment. Plasma cytokine levels were compared using a cytometric bead array.ResultsTrichuris and Ascaris infections were linked to increased frequencies of “activated” CD4 and/or CD8 T cells (p<0.05), whereas Hookworm infection was associated with a trend towards decreased HLA-DR+ CD8 T cell frequencies (p = 0.222). In Trichuris infected subjects, there was a linear correlation between HLA-DR+ CD4 T cell frequencies and the cytokines IL-1β and IL-10 (p<0.05). Helminth treatment with Albendazole and Praziquantel significantly decreased eosinophilia for S. mansoni and Hookworm infections (p<0.005) but not for Trichuris infection and only moderately modulated T cell activation. CCR5 surface density on memory CD4 T cells was increased by 1.2-fold during Trichuris infection (p-value: 0.053) and reduced after treatment (p = 0.003).ConclusionsIncreased expression of T cell activation markers was associated with Trichuris and Ascaris infections with relatively little effect of helminth treatment.

Antihelminthics in helminth-endemic areas: effects on HIV disease progression

“…We pooled the results from included RCTs in six different meta-analyses, using a random-effects method, due to the heterogeneity of the interventions (DerSimonian 1986). We performed pooled meta-analyses to assess the outcomes of change in mean plasma viral load in populations with unknown helminth infection status, change in mean CD4+ cell count in populations with unknown helminth infection status, change in mean plasma viral load in helminth-infected populations only, change in mean CD4+ cell count in helminth-infected populations only, difference in adverse events, and difference in mortality events.…”

CD25+FoxP3+Memory CD4 T Cells Are Frequent Targets of HIV InfectionIn Vivo

“…The WHIS cohort comprised 361 adult volunteers who were enrolled in a prospective cohort (WHIS) that studies the interaction between HIV-1 and helminth infection in the Mbeya region in southwestern Tanzania. The WHIS cohort study is described in detail elsewhere (37). HIV status was determined using the HIV 1/2 Stat-Pak assay (Chembio Diagnostics Systems), and positive results were confirmed using an enzyme-linked immunosorbent assay (ELISA; Bio-Rad).…”

“…Table 1 provides an overview of the subjects included in this study. A total of 258 HIV-negative and 103 HIVpositive adults (mean age, 34.3 years) from the WHIS cohort (37) were included in this study, of which 217 (60%) were female. The vast majority of HIV ϩ subjects from the WHIS cohort were treatment naive (97%), with a median CD4 ϩ T cell count of 396.3 cells/l and median log 10 plasma viral load of 4.7 copies/ml.…”

Selected aspects of helminth infections Schistosoma sp., Ascaris lumbricoides, Strongyloides stercoralis in individuals diagnosed with human immunodeficiency virus (HIV) infection

“…Schistosoma, Toxocara spp.) during their life cycle may lead to direct mechanical tissue damage or to injuries caused by immune reactions in the mechanism of hypersensitivity of all types (28,29).…”