title: Schistosomiasis and HIV-1 infection in rural Zimbabwe: implications of coinfection for excretion of eggs.
abstract: BACKGROUND
  Stunted development and reduced fecundity of Schistosoma parasites in immunodeficient mice and the impaired ability of human immunodeficiency virus 1 (HIV-1)-infected humans to excrete schistosome eggs have been described. This study explores the effect that HIV-1-associated immunodeficiency has on the excretion of schistosome eggs in a large cohort of coinfected individuals.
  
  
  METHODS
  In a cross-sectional survey, urine and stool samples were obtained from and HIV-1 status was determined for 1545 individuals. More extensive data, including quantitative measures of intensity of infection in schistosomiasis and immunodeficiency, were collected in the Mupfure schistosomiasis and HIV longitudinal cohort, composed of 379 participants of whom 154 were coinfected with HIV-1 and Schistosoma parasites.
  
  
  RESULTS
  In the cross-sectional survey, the overall prevalence of schistosomiasis was 43.4%, and 26.3% of the participants were infected with HIV-1. Schistosome infections were due to Schistosoma haematobium in 63.6% of cases, S. mansoni in 18.1% of cases, and dual infections in 18.4% of cases. Intensities of Schistosoma infections, measured by the number of eggs excreted and by the level of circulating anodic antigens, did not differ between HIV-1-negative and HIV-1-positive participants coinfected with S. haematobium, S. mansoni, or both. CD4 cell counts were significantly lower in HIV-1-positive participants and in S. mansoni-infected HIV-1-negative participants than in other participants.
  
  
  CONCLUSIONS
  The present study suggests that adult HIV-1-related immunodeficiency does not impair the ability to excrete eggs in low-intensity infection with S. haematobium, S. mansoni, or both and that infection with HIV-1 may not have major implications for diagnosis and surveillance of schistosomiasis.
authors.affiliation: Center of Inflammation and Metabolism, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark. kallestrup@dadlnet.dk
authors.forename: Per
authors.initials: P
authors.lastname: Kallestrup
authors.forename: Rutendo
authors.initials: R
authors.lastname: Zinyama
authors.forename: Exnevia
authors.initials: E
authors.lastname: Gomo
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Butterworth
authors.forename: Govert J
authors.initials: GJ
authors.lastname: van Dam
authors.forename: Christian
authors.initials: C
authors.lastname: Erikstrup
authors.forename: Henrik
authors.initials: H
authors.lastname: Ullum
mesh_terms: D000328:Adult; D017677:Age Distribution; D015992:Body Mass Index; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000276:immunology / Q000469:parasitology; D006801:Humans; D008297:Male; D010270:Parasite Egg Count; D012044:Regression Analysis; D012423:Rural Health / Q000706:statistics & numerical data*; D012552:Schistosomiasis / Q000150:complications* / Q000453:epidemiology / Q000469:parasitology* / Q000652:urine; D014556:Urine / Q000469:parasitology*; D015030:Zimbabwe / Q000453:epidemiology