Schistosomiasis and HIV-1 infection in rural Zimbabwe: effect of treatment of schistosomiasis on CD4 cell count and plasma HIV-1 RNA load.
To determine whether treatment of schistosomiasis has an effect on the course of human immunodeficiency virus type 1 (HIV-1) infection, individuals with schistosomiasis and with or without HIV-1 infection were randomized to receive praziquantel treatment at inclusion or after a delay of 3 months; 287 participants were included in the study, and 227 (79%) were followed up. Among the 130 participants who were coinfected, those who received early treatment (n=64) had a significantly lower increase in plasma HIV-1 RNA load than did those who received delayed treatment (n=66) (P<.05); this difference was associated with no change in plasma HIV-1 RNA load in the early intervention group (P=.99) and an increase in plasma HIV-1 RNA load in the delayed intervention group (P<.01). Among the 227 participants who were followed up, those who received early treatment (n=105) had an increase in CD4 cell count, whereas those who received delayed treatment (n=122) did not (P<.05); this effect did not differ between participants when stratified by HIV-1 infection status (P=.17). The present study suggests that treatment of schistosomiasis can reduce the rate of viral replication and increase CD4 cell count in the coinfected host.
Kallestrup
Per
P
Center for Inflammation and Metabolism, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark. kallestrup@dadlnet.dk
Zinyama
Rutendo
R
Gomo
Exnevia
E
Butterworth
Anthony E
AE
Mudenge
Boniface
B
van Dam
Govert J
GJ
Gerstoft
Jan
J
Erikstrup
Christian
C
Ullum
Henrik
H
D000328:Adult; D000871:Anthelmintics / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D008297:Male; D011223:Praziquantel / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood* / Q000187:drug effects; D012424:Rural Population; D012552:Schistosomiasis / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D016896:Treatment Outcome; D019562:Viral Load; D015030:Zimbabwe
D000871:Anthelmintics; D012367:RNA, Viral; D011223:Praziquantel