HIV Target Cells in Schistosoma haematobium-Infected Female Genital Mucosa

Jourdan, P; Holmen, Sigve; Gundersen, Svein Gunnar; Roald, Borghild; Kjetland, Eyrun Floerecke

doi:10.4269/ajtmh.2011.11-0135

Cited by 57 publications

(55 citation statements)

References 40 publications

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“…A previous study reported high levels of CD4 + T-cells around calcified ova typical of chronic infection [20]. As our study found an apparent lack of effect of treatment on CD4 + T-cells in the genital compartment, this may indicate that there is a long-term, possibly refractory effect of schistosomal infection.…”

Section: Discussionsupporting

confidence: 43%

Effect of Female Genital Schistosomiasis and Anti-Schistosomal Treatment on Monocytes, CD4+ T-Cells and CCR5 Expression in the Female Genital Tract

Kleppa

Ramsuran

Zulu³

et al. 2014

PLoS ONE

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Background Schistosoma haematobium is a waterborne parasite that may cause female genital schistosomiasis (FGS), characterized by genital mucosal lesions. There is clinical and epidemiological evidence for a relationship between FGS and HIV. We investigated the impact of FGS on HIV target cell density and expression of the HIV co-receptor CCR5 in blood and cervical cytobrush samples. Furthermore we evaluated the effect of anti-schistosomal treatment on these cell populations.DesignThe study followed a case-control design with post treatment follow-up, nested in an on-going field study on FGS.MethodsBlood and cervical cytobrush samples were collected from FGS negative and positive women for flow cytometry analyses. Urine samples were investigated for schistosome ova by microscopy and polymerase chain reaction (PCR).ResultsFGS was associated with a higher frequency of CD14+ cells (monocytes) in blood (11.5% in FGS+ vs. 2.2% in FGS-, p = 0.042). Frequencies of CD4+ cells expressing CCR5 were higher in blood samples from FGS+ than from FGS- women (4.7% vs. 1.5%, p = 0.018). The CD14+ cell population decreased significantly in both compartments after anti-schistosomal treatment (p = 0.043). Although the frequency of CD4+ cells did not change after treatment, frequencies of CCR5 expression by CD4+ cells decreased significantly in both compartments (from 3.4% to 0.5% in blood, p = 0.036; and from 42.4% to 5.6% in genital samples, p = 0.025).ConclusionsThe results support the hypothesis that FGS may increase the risk of HIV acquisition, not only through damage of the mucosal epithelial barrier, but also by affecting HIV target cell populations, and that anti-schistosomal treatment can modify this.

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Section: Discussionsupporting

confidence: 43%

Effect of Female Genital Schistosomiasis and Anti-Schistosomal Treatment on Monocytes, CD4+ T-Cells and CCR5 Expression in the Female Genital Tract

Kleppa

Ramsuran

Zulu³

et al. 2014

PLoS ONE

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“…Several cross-sectional epidemiological studies have reported that in regions most heavily affected by the HIV/AIDS pandemic, women with FGS have a three-to fourfold increased odds of having HIV compared with women without FGS (4-6). The FGS-mediated breach in the epithelial barriers of the cervix, as well as inflammation of the genital mucosal tissues, appears to increase HIV susceptibility (4,7). The strong statistical association between FGS and HIV, the biological plausibility of the association, and the observation that schistosomal genital lesions are common in FGS-infected women before puberty (3,5,6) together provide convincing evidence that FGS is a significant risk factor for HIV infection in sub-Saharan Africa.…”

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confidence: 78%

Cost-effectiveness of a community-based intervention for reducing the transmission of Schistosoma haematobium and HIV in Africa

Ndeffo-Mbah

Kjetland

Atkins

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

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Epidemiological studies from sub-Saharan Africa show that genital infection with Schistosoma haematobium may increase the risk for HIV infection in young women. Therefore, preventing schistosomiasis has the potential to reduce HIV transmission in sub-Saharan Africa. We developed a transmission model of female genital schistosomiasis and HIV infections that we fit to epidemiological data of HIV and female genital schistosomiasis prevalence and coinfection in rural Zimbabwe. We used the model to evaluate the cost-effectiveness of a multifaceted community-based intervention for preventing schistosomiasis and, consequently, HIV infections in rural Zimbabwe, from the perspective of a health payer. The community-based intervention combined provision of clean water, sanitation, and health education (WSH) with administration of praziquantel to school-aged children. Considering variation in efficacy between 10% and 70% of WSH for reducing S. haematobium transmission, our model predicted that community-based intervention is likely to be cost-effective in Zimbabwe at an aggregated WSH cost corresponding to US $725–$1,000 per individual over a 20-y intervention period. These costs compare favorably with empirical measures of WSH provision in developing countries, indicating that integrated community-based intervention for reducing the transmission of S. haematobium is an economically attractive strategy for reducing schistosomiasis and HIV transmission in sub-Saharan Africa that would have a powerful impact on averting infections and saving lives.

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“…Up to 75% of girls and women with chronic S. haematobium infection may be affected by deposition of eggs with granulomas and sandy patches on the cervix and, moreover, histopathological interpretation of biopsy specimens indicates that this increases the vascular density of the genital mucosa [5]. The resulting FGS has been associated with contact bleeding, discharge, pain on intercourse as well as diminished fertility [6][7][8].…”

Section: Female Genital Schistosomiasismentioning

confidence: 98%

New biomarkers to fight urogenital schistosomiasis: a major neglected tropical disease

Botelho

Sousa

2014

Biomarkers in Medicine

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HIV Target Cells in Schistosoma haematobium-Infected Female Genital Mucosa

Cited by 57 publications

References 40 publications

Effect of Female Genital Schistosomiasis and Anti-Schistosomal Treatment on Monocytes, CD4+ T-Cells and CCR5 Expression in the Female Genital Tract

Effect of Female Genital Schistosomiasis and Anti-Schistosomal Treatment on Monocytes, CD4+ T-Cells and CCR5 Expression in the Female Genital Tract

Cost-effectiveness of a community-based intervention for reducing the transmission of Schistosoma haematobium and HIV in Africa

New biomarkers to fight urogenital schistosomiasis: a major neglected tropical disease

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