Schistosoma mansoni Enhances Host Susceptibility to Mucosal but Not Intravenous Challenge by R5 Clade C SHIV

Siddappa, Nagadenahalli B.; Hemashettar, Girish; Shanmuganathan, Vivekanandan; Semenya, Amma A.; Sweeney, Elizabeth; Paul, Katherine; Lee, Sandra J.; Secor, W. Evan; Ruprecht, Ruth M.

doi:10.1371/journal.pntd.0001270

Cited by 26 publications

(27 citation statements)

References 28 publications

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“…In support of this hypothesis, rhesus macaques with acute S. mansoni infection were found to be more susceptible to development of systemic HIV infection after rectal HIV exposure than were macaques without S. mansoni [40]. Because macaques did not have statistically-significant differences in the rates of HIV infection after intravenous HIV exposure, the authors concluded that the increased host susceptibility to HIV in the setting of schistosomal infection that they observed was predominantly due to mucosal inflammation [40].…”

Section: Resultsmentioning

confidence: 91%

Examining the Relationship between Urogenital Schistosomiasis and HIV Infection

et al. 2011

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BackgroundUrogenital schistosomiasis, caused by infection with Schistosoma haematobium, is widespread and causes substantial morbidity on the African continent. The infection has been suggested as an unrecognized risk factor for incident HIV infection. Current guidelines recommend preventive chemotherapy, using praziquantel as a public health tool, to avert morbidity due to schistosomiasis. In individuals of reproductive age, urogenital schistosomiasis remains highly prevalent and, likely, underdiagnosed. This comprehensive literature review was undertaken to examine the evidence for a cause-effect relationship between urogenital schistosomiasis and HIV/AIDS. The review aims to support discussions of urogenital schistosomiasis as a neglected yet urgent public health challenge.Methodology/Principal FindingsWe conducted a systematic search of the literature including online databases, clinical guidelines, and current medical textbooks. We describe plausible local and systemic mechanisms by which Schistosoma haematobium infection could increase the risk of HIV acquisition in both women and men. We also detail the effects of S. haematobium infection on the progression and transmissibility of HIV in co-infected individuals. We briefly summarize available evidence on the immunomodulatory effects of chronic schistosomiasis and the implications this might have for populations at high risk of both schistosomiasis and HIV.Conclusions/SignificanceStudies support the hypothesis that urogenital schistosomiasis in women and men constitutes a significant risk factor for HIV acquisition due both to local genital tract and global immunological effects. In those who become HIV-infected, schistosomal co-infection may accelerate HIV disease progression and facilitate viral transmission to sexual partners. Establishing effective prevention strategies using praziquantel, including better definition of treatment age, duration, and frequency of treatment for urogenital schistosomiasis, is an important public health priority. Our findings call attention to this pressing yet neglected public health issue and the potential added benefit of scaling up coverage of schistosomal treatment for populations in whom HIV infection is prevalent.

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Section: Resultsmentioning

confidence: 91%

Examining the Relationship between Urogenital Schistosomiasis and HIV Infection

et al. 2011

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“…Bloody discharge may be a result of this. Inter-menstrual bleeding, post-coital bleeding, malodorous and abnormally colored discharge and genital itch have been found to be associated with S. haematobium ova in the genitals of adults, even after correcting for sexually transmitted diseases [1], [19], [25], [34].…”

Section: Discussionmentioning

confidence: 99%

“…Most importantly, these women have been found to have significantly more HIV [16], [17], [18], [19]. In the wake of the HIV epidemic and a realistic prospect of successful anti-schistosomal mass-treatment programs this study sought to explore if girls before sexual debut had signs of genital disease [20].…”

Section: Introductionmentioning

confidence: 99%

S. haematobium as a Common Cause of Genital Morbidity in Girls: A Cross-sectional Study of Children in South Africa

et al. 2013

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Background Schistosoma (S.) haematobium infection is a common cause of genital morbidity in adult women. Ova in the genital mucosal lining may cause lesions, bleeding, pain, discharge, and the damaged surfaces may pose a risk for HIV. In a heterogeneous schistosomiasis endemic area in South Africa, we sought to investigate if young girls had genital symptoms and if this was associated with urinary S. haematobium.MethodologyIn a cross-sectional study of 18 randomly chosen primary schools, we included 1057 schoolgirls between the age of 10 and 12 years. We interviewed assenting girls, whose parents had consented to their participation and examined three urines from each of them for schistosome ova.Principal findingsOne third of the girls reported to have a history of genital symptoms. Prior schistosomal infection was reported by 22% (226/1020), this was associated with current genital symptoms (p<0.001). In regression analysis the genital symptoms were significantly associated both with urinary schistosomiasis (p<0.001) and water contact (p<0.001).ConclusionsEven before sexually active age, a relatively large proportion of the participating girls had similar genital symptoms to those reported for adult genital schistosomiasis previously. Anti-schistosomal treatment should be considered at a young age in order to prevent chronic genital damage and secondary infections such as HIV, sexually transmitted diseases and other super-infections.

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“…4 In contrast, prior S. mansoni infection did not significantly change the required infectious dose when SHIV was inoculated intravenously. 4,27 Researchers postulated that S. mansoni infection increased the number of activated CD4+ T cells in the gut-associated lymphoid tissue (GALT) and thereby increased the optimal targets for SHIV infection. Mouse models of schistosomiasis show that S. mansoni eggs induce a Th17 CD4+ T-cell response in the gut mucosa.…”

Section: Discussionmentioning

confidence: 99%

Association of Schistosomiasis and HIV Infection in Tanzania

Downs

Dam²,

Changalucha³

et al. 2012

The American Society of Tropical Medicine and Hygiene

100

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Abstract. Animal and human studies suggest that Schistosoma mansoni infection may increase risk of human immunodeficiency virus (HIV) acquisition. Therefore, we tested 345 reproductive age women in rural Tanzanian villages near Lake Victoria, where S. mansoni is hyperendemic, for sexually transmitted infections (STIs) and schistosomiasis by circulating anodic antigen (CAA) serum assay. Over one-half (54%) had an active schistosome infection; 6% were HIVseropositive. By univariate analysis, only schistosome infection predicted HIV infection (odds ratio [OR] = 3.9, 95% confidence interval = [1.3-12.0], P = 0.015) and remained significant using multivariate analysis to control for age, STIs, and distance from the lake (OR = 6.2 [1.7-22.9], P = 0.006). HIV prevalence was higher among women with more intense schistosome infections (P = 0.005), and the median schistosome intensity was higher in HIV-infected than -uninfected women (400 versus 15 pg CAA/mL, P = 0.01). This finding suggests that S. mansoni infection may be a modifiable HIV risk factor that places millions of people worldwide at increased risk of HIV acquisition.

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Schistosoma mansoni Enhances Host Susceptibility to Mucosal but Not Intravenous Challenge by R5 Clade C SHIV

Cited by 26 publications

References 28 publications

Examining the Relationship between Urogenital Schistosomiasis and HIV Infection

Examining the Relationship between Urogenital Schistosomiasis and HIV Infection

S. haematobium as a Common Cause of Genital Morbidity in Girls: A Cross-sectional Study of Children in South Africa

Association of Schistosomiasis and HIV Infection in Tanzania

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