title: Treatment of Schistosoma mansoni infection increases helminth-specific type 2 cytokine responses and HIV-1 loads in coinfected Ugandan adults.
abstract: BACKGROUND
  Studies showing that helminths stimulate type 2 cytokine responses and influence responses to unrelated antigens suggest that helminths may accelerate human immunodeficiency virus type 1 (HIV-1) disease progression in coinfected individuals and that antihelminthic therapy may be beneficial. By the same logic, however, the increase in type 2 cytokines occurring immediately after antischistosomal treatment might increase viral replication and be detrimental.
  
  
  METHODS
  To assess the effect of antischistosomal therapy on immune responses and HIV-1 replication, a cohort of 163 Ugandans coinfected with Schistosoma mansoni and HIV-1 was treated with praziquantel. CD4(+) T lymphocyte counts, eosinophil counts, and plasma HIV-1 RNA concentrations were measured before treatment and 1 month and 5 months after treatment. Schistosoma mansoni- and Mycobacterium tuberculosis-specific cytokine responses and serum interleukin (IL)-10 concentrations were analyzed.
  
  
  RESULTS
  Transient increases in viral load and sustained decreases in CD4(+) T lymphocyte count were observed, especially in subjects with higher-intensity infections. Despite enhanced posttreatment S. mansoni-specific type 2 responses, no increase in eosinophils or in M. tuberculosis-specific type 2 responses nor any decline in M. tuberculosis-specific interferon (IFN)-gamma responses were seen. A significant decline in circulating IL-10 concentrations was observed.
  
  
  CONCLUSIONS
  Although the mechanisms underlying the increase in viral load after treatment with praziquantel are unclear, these results do not support the hypothesis that treating schistosomiasis is beneficial in the management of HIV-1 disease in Africa.
authors.affiliation: Uganda Virus Research Institute, Entebbe, Uganda. michael.brown@lshtm.ac.uk
authors.forename: Michael
authors.initials: M
authors.lastname: Brown
authors.forename: Patrice A
authors.initials: PA
authors.lastname: Mawa
authors.forename: Sarah
authors.initials: S
authors.lastname: Joseph
authors.forename: Joseph
authors.initials: J
authors.lastname: Bukusuba
authors.forename: Christine
authors.initials: C
authors.lastname: Watera
authors.forename: James A G
authors.initials: JA
authors.lastname: Whitworth
authors.forename: David W
authors.initials: DW
authors.lastname: Dunne
authors.forename: Alison M
authors.initials: AM
authors.lastname: Elliott
mesh_terms: D000328:Adult; D000871:Anthelmintics / Q000009:adverse effects* / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D007378:Interleukins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011223:Praziquantel / Q000009:adverse effects* / Q000627:therapeutic use; D012367:RNA, Viral / Q000097:blood; D012555:Schistosomiasis mansoni / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D014454:Uganda; D019562:Viral Load; D014779:Virus Replication
chemical_list: D000871:Anthelmintics; D007378:Interleukins; D012367:RNA, Viral; D011223:Praziquantel; D007371:Interferon-gamma