title: Association between CD4+ T-lymphocyte counts and fecal excretion of Schistosoma mansoni eggs in patients coinfected with S. mansoni and human immunodeficiency virus before and after initiation of antiretroviral therapy.
abstract: Previously, we have shown that persons with human immunodeficiency virus 1 (HIV-1) infection and reduced CD4(+) T-lymphocyte counts excrete significantly fewer Schistosoma mansoni eggs than HIV-1-negative persons with similar intensities of schistosome infections. To determine how antiretroviral therapy (ART) might affect egg excretion, we conducted a study of HIV+ adults living in an area highly endemic for S. mansoni as they began an ART program. Fecal egg excretion and CD4(+) T-lymphocyte counts were evaluated at enrollment as well as 2 and 4 weeks after initiation of ART. Fourteen individuals who were Kato-Katz-negative at enrollment subsequently started excreting S. mansoni eggs accompanied by a significant increase in CD4(+) T lymphocytes (P = 0.004). Study participants who were S. mansoni egg-positive at enrollment and received both praziquantel and ART also showed significantly increased CD4(+) T-lymphocyte counts compared with baseline (P < 0.0001). Our data support a role for CD4(+) T lymphocytes in S. mansoni egg excretion.
authors.affiliation: Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.
authors.forename: Erick M O
authors.initials: EM
authors.lastname: Muok
authors.forename: Elses W
authors.initials: EW
authors.lastname: Simiyu
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Ochola
authors.forename: Zipporah W
authors.initials: ZW
authors.lastname: Ng'ang'a
authors.forename: W Evan
authors.initials: WE
authors.lastname: Secor
authors.forename: Diana M S
authors.initials: DM
authors.lastname: Karanja
authors.forename: Pauline N M
authors.initials: PN
authors.lastname: Mwinzi
mesh_terms: D000328:Adult; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000188:drug therapy / Q000469:parasitology / Q000821:virology; D005243:Feces / Q000469:parasitology* / Q000821:virology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000469:parasitology; D015497:HIV-1; D006801:Humans; D010270:Parasite Egg Count; D011223:Praziquantel / Q000627:therapeutic use; D012550:Schistosoma mansoni; D012555:Schistosomiasis mansoni / Q000150:complications* / Q000188:drug therapy / Q000469:parasitology / Q000821:virology
chemical_list: D000871:Anthelmintics; D019380:Anti-HIV Agents; D011223:Praziquantel