Interactions Between Schistosoma Haematobium and Human Immunodeficiency Virus Type 1: The Effects of Coinfection on Treatment Outcomes in Rural Zambia

Mwanakasale, Victor; Vounatsou, Penelope; Sukwa, Thomas; Ziba, Macduff; Ernest, Arthur; Tanner, Marcel

doi:10.4269/ajtmh.2003.69.420

Cited by 57 publications

(65 citation statements)

References 25 publications

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“…Other studies using a variety of diagnostic methods in various at-risk populations have shown a wide variance in schistosomiasis prevalence in endemic countries. Twenty per cent of adults in rural Nigeria [16], 40% of adults in rural Zambia [17], and 68% of children in rural South Africa [18] were infected with schistosomiasis. Among African migrants to Australia, 12% of those attending general practice in Melbourne [19] and 7% of those attending the Migrant Health Unit in Perth [20] were found to be infected with schistosomiasis.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of schistosomiasis in African patients infected with HIV

Smith¹,

Smith²,

Seaton³

et al. 2008

HIV Medicine

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Schistosomiasis is a highly prevalent parasitic infection causing significant morbidity and mortality in sub-Saharan Africa. Infection is asymptomatic for many years. Long-term complications such as portal hypertension and bladder cancer can be prevented by treatment with praziquantel. ObjectivesThe aim of this study was to determine the prevalence of schistosomiasis in HIV-infected African patients attending our department. MethodsFrom March 2005, all patients of African origin attending our HIV clinics were tested for schistosomal antibodies using a peroxidase enzyme-linked immunosorbent assay (ELISA). Stool and urine specimens from seropositive patients were examined for ova. All seropositive patients were offered treatment with praziquantel. ResultsOf 122 patients tested, 21 (17%) were ELISA positive for schistosomiasis. Ova were found in stools from four patients and on a cervical smear in one patient. There were no significant differences between infected and uninfected patients other than the presence of eosinophilia (48 vs. 6%; Po0.001), and 17 seropositive patients were treated with praziquantel. ConclusionsThe seroprevalence of schistosomiasis in HIV-infected patients of African origin in the UK is high. We recommend that screening for schistosomiasis should be offered to these patients and those found to be positive treated with praziquantel.

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Section: Discussionmentioning

confidence: 99%

Seroprevalence of schistosomiasis in African patients infected with HIV

Smith¹,

Smith²,

Seaton³

et al. 2008

HIV Medicine

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“…One study along these lines showed that cure rates in HIV-positive subjects were as high as in HIV-negatives (Karanja et al 1998 ;Mwanakasale et al 2003), but the reason for this ' negative ' result may be that despite the viral infection the former already had the synergistically-active immune effector mechanisms in place.…”

Section: Mechanisms Of Action Of Pzq and Markers Of Resistancementioning

confidence: 99%

Praziquantel: its use in control of schistosomiasis in sub-Saharan Africa and current research needs

et al. 2009

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S U M M A R YTreatment with praziquantel (PZQ) has become virtually the sole basis of schistosomiasis control in sub-Saharan Africa and elsewhere, and the drug is reviewed here in the context of the increasing rate that it is being used for this purpose. Attention is drawn to our relative lack of knowledge about the mechanisms of action of PZQ at the molecular level, the need for more work to be done on schistosome isolates that have been collected recently from endemic areas rather than those maintained in laboratory conditions for long periods, and our reliance for experimental work mainly on Schistosoma mansoni, little work having been done on S. haematobium. There is no evidence that resistance to PZQ has been induced in African schistosomes as a result of its large-scale use on that continent to date, but there is also no assurance that PZQ and/ or schistosomes are in any way unique and that resistant organisms will not be selected as a result of widespread drug usage. The failure of PZQ to produce complete cures in populations given a routine treatment should therefore solicit considerable concern. With few alternatives to PZQ currently available and/or on the horizon, methods to monitor drug-susceptibility in African schistosomes need to be devised and used to help ensure that this drug remains effective for as long a time as possible.

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“…Schistosomiasis, in addition to its direct morbidity, may affect HIV-1 infection by causing general immune activation and by changing the pattern of cytokine secretion. Despite the large potential for dual occurrence of HIV-1 infection and schistosomiasis, only a few studies have described how these may interact [9][10][11][12][13]. These studies have suggested that an impaired schistosome egg excretion [9,10], a dysregulated immune response against schistosome infection [11], and even an increase in HIV-1 RNA load after praziquantel treatment [12,13] occur in individuals coinfected with HIV-1 and schistosomes.…”

Section: B R I E F R E P O R Tmentioning

confidence: 99%

Schistosomiasis and HIV‐1 Infection in Rural Zimbabwe: Effect of Treatment of Schistosomiasis on CD4 Cell Count and Plasma HIV‐1 RNA Load

et al. 2005

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To determine whether treatment of schistosomiasis has an effect on the course of human immunodeficienc virus type 1 (HIV-1) infection, individuals with schistosomiasis and with or without HIV-1 infection were randomized to receive praziquantel treatment at inclusion or after a delay of 3 months; 287 participants were included in the study, and 227 (79%) were followed up. Among the 130 participants who were coinfected, those who received early treatment ( ) had a n p 64 significantl lower increase in plasma HIV-1 RNA load than did those who received delayed treatment ( ) ( ); n p 66 P ! .05 this difference was associated with no change in plasma HIV-1 RNA load in the early intervention group ( ) and an P p .99 increase in plasma HIV-1 RNA load in the delayed intervention group ( ). Among the 227 participants who were fol-P ! .01 lowed up, those who received early treatment ( ) had n p 105 an increase in CD4 cell count, whereas those who received delayed treatment ( ) did not ( ); this effect did n p 122 P ! .05 not differ between participants when stratifie by HIV-1 infection status (). The present study suggests that treat-P p .17 ment of schistosomiasis can reduce the rate of viral replication and increase CD4 cell count in the coinfected host.Immune activation caused by a higher prevalence of concurrent infections has been hypothesized to be a driving factor for in-

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Interactions Between Schistosoma Haematobium and Human Immunodeficiency Virus Type 1: The Effects of Coinfection on Treatment Outcomes in Rural Zambia

Cited by 57 publications

References 25 publications

Seroprevalence of schistosomiasis in African patients infected with HIV

Seroprevalence of schistosomiasis in African patients infected with HIV

Praziquantel: its use in control of schistosomiasis in sub-Saharan Africa and current research needs

Schistosomiasis and HIV‐1 Infection in Rural Zimbabwe: Effect of Treatment of Schistosomiasis on CD4 Cell Count and Plasma HIV‐1 RNA Load

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