The effect of treatment of schistosomiasis on blood plasma HIV-1 RNA concentration in coinfected individuals.
OBJECTIVE
To determine whether drug treatment of Schistosomiasis mansoni infection leads to a reduction in plasma HIV-1 RNA concentration in coinfected individuals.


METHODS
Stool and plasma samples were obtained prospectively from a cohort of HIV-infected persons (n = 30) in Kisumu, Kenya, before and after treatment of schistosomiasis with praziquantel (mean follow-up, 5.6 months; range 1-15 months). Schistosomal circulating cathodic antigen (CCA) concentrations in plasma were determined by ELISA and fecal egg counts were determined by microscopy. HIV-1 RNA concentrations were measured in pre- and post-treatment plasma samples obtained from the patients whose stool samples remained free of schistosomal eggs for the great majority of the follow-up period.


RESULTS
Comparison of pretreatment and follow-up samples revealed that mean +/- SD fecal egg burden was reduced by 96.7% (481.5+/-803.5 versus 16.1+/-24.4 eggs/g feces) and mean plasma CCA concentration decreased by 90.1% (3.22+/-3.26 versus 0.32+/-0.38 microg/ml). In contrast, mean plasma HIV-1 load increased from 3.60+/-0.90 to 3.93+/-0.95 log10 RNA copies/ml (P< 0.001). Although no correlation was found between changes in HIV-1 load and changes in schistosomal burden, there was a significant correlation between changes in plasma HIV load and the time interval between pretreatment and follow-up samples (r = 0.41; P = 0.027).


CONCLUSIONS
Treatment of schistosomiasis was not associated with a reduction in plasma HIV-1 load. This study does not, however, exclude the possibility of an adverse effect of helminthic infections on HIV-1 pathogenesis.
Lawn
S D
SD
HIV and Retrovirology Branch, Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia 30333, USA.
Karanja
D M
DM
Mwinzia
P
P
Andove
J
J
Colley
D G
DG
Folks
T M
TM
Secor
W E
WE
D000328:Adult; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D000947:Antigens, Helminth / Q000097:blood; D005243:Feces / Q000469:parasitology; D015658:HIV Infections / Q000150:complications / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D008297:Male; D010270:Parasite Egg Count; D011223:Praziquantel / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood*; D012550:Schistosoma mansoni / Q000302:isolation & purification; D012555:Schistosomiasis mansoni / Q000150:complications / Q000188:drug therapy*
D000871:Anthelmintics; D000947:Antigens, Helminth; D012367:RNA, Viral; D011223:Praziquantel