Increased Prevalence of Leukocytes and Elevated Cytokine Levels in Semen fromSchistosoma haematobium–Infected Individuals

Abstract

In this study, we investigated the seminal inflammatory response to egg infestation of the urogenital organs in 240 semen-donating men aged 15-49 years living in a Schistosoma haematobium-endemic area of Madagascar. In 29 subjects (12%) with excretion of > or =5 ova/ejaculate, leukocytospermia (>10(6) leukocytes/mL) and the presence of seminal lymphocytes and eosinophil leukocytes were each significantly more prevalent than in 74 subjects (31%) who were S. haematobium negative (P<.01). In addition, seminal levels of interleukin (IL)-4, IL-6, IL-10, and tumor necrosis factor- alpha were significantly higher among seminal egg-excreting subjects than among infection-negative subjects (P<.001). Sexually transmitted infection (STI) with Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, and/or Trichomonas vaginalis did not act as a confounding factor for the observed associations. At follow-up, 6 months after systematic antischistosomiasis and STI syndrome treatment at baseline, the prevalence of seminal leukocytes decreased significantly among the previously seminal egg-positive subjects. The same tendency was observed for the posttreatment levels of cytokines. Numerous studies have already shown an association between STI-associated genital inflammation and human immunodeficiency virus (HIV) propagation. Therefore, the results of the present study suggest that male urogenital schistosomiasis may constitute a risk factor for HIV transmission, as a result of egg-induced inflammation in the semen-producing pelvic organs.

Schistosomiasis and Human Immunodeficiency Virus in Men in Tanzania

“…25 Semen of infected men frequently contains S. haematobium ova, together with increased seminal levels of leukocytes and the inflammatory cytokines interleukin (IL)-4, IL-6, IL-10, and tumor necrosis factor alpha (TNF-α). 26 These findings and ours support the hypothesis that men with urogenital schistosomiasis may more easily transmit HIV to their sexual partners due to tissue inflammation and bleeding, leading to higher concentrations of HIV in the semen of HIVschistosome coinfected men than in HIV-infected men without schistosome infection. 26,27 A recent prospective study demonstrated that men and women with the helminthic infection lymphatic filariasis had a 2-fold increased risk of incident HIV infection compared with those without filariasis.…”

“…26 These findings and ours support the hypothesis that men with urogenital schistosomiasis may more easily transmit HIV to their sexual partners due to tissue inflammation and bleeding, leading to higher concentrations of HIV in the semen of HIVschistosome coinfected men than in HIV-infected men without schistosome infection. 26,27 A recent prospective study demonstrated that men and women with the helminthic infection lymphatic filariasis had a 2-fold increased risk of incident HIV infection compared with those without filariasis. 28 Unlike schistosomiasis, filariasis is not known to have direct effects on the genital tract, suggesting that systemic immune changes induced by filariasis could increase HIV susceptibility.…”

“…To participate in the study, men were asked to provide written informed consent or place their mark on the consent form. [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. Nearly half of the men (328, 48.7%) had had more than one sexual partner in the past 6 months, and the majority of men reported that their sexual partners were typically more than 5 years younger.…”

Schistosomiasis PCR in Vaginal Lavage as an Indicator of Genital Schistosoma haematobium Infection in Rural Zimbabwean Women

“…4 False positive cases may be caused by the fact that S. haematobium ova can also be found in sperm and history of sexual intercourse was not recorded in this study. 22 The contamination from the outer genitals by urine or contamination from previous analyses (e.g., the practice of recycling/reusing slides/filters) was not an issue in this study.…”

Coinfection with HIV and Tropical Infectious Diseases. II. Helminthic, Fungal, Bacterial, and Viral Pathogens

“…Increased susceptibility to reinfection has also been observed [26]. Finally, female [27] (and, likely, male [28]) urogenital schistosomiasis due to S. haematobium increases the risk for HIV transmission. To date, the literature is lacking regarding significant interactions between HIV and intestinal, hepatic, or pulmonary trematodes.…”