title: Effect of female genital schistosomiasis and anti-schistosomal treatment on monocytes, CD4+ T-cells and CCR5 expression in the female genital tract.
abstract: BACKGROUND
  Schistosoma haematobium is a waterborne parasite that may cause female genital schistosomiasis (FGS), characterized by genital mucosal lesions. There is clinical and epidemiological evidence for a relationship between FGS and HIV. We investigated the impact of FGS on HIV target cell density and expression of the HIV co-receptor CCR5 in blood and cervical cytobrush samples. Furthermore we evaluated the effect of anti-schistosomal treatment on these cell populations.
  
  
  METHODS
  The study followed a case-control design with post treatment follow-up, nested in an on-going field study on FGS.
  
  
  METHODS
  Blood and cervical cytobrush samples were collected from FGS negative and positive women for flow cytometry analyses. Urine samples were investigated for schistosome ova by microscopy and polymerase chain reaction (PCR).
  
  
  RESULTS
  FGS was associated with a higher frequency of CD14+ cells (monocytes) in blood (11.5% in FGS+ vs. 2.2% in FGS-, p = 0.042). Frequencies of CD4+ cells expressing CCR5 were higher in blood samples from FGS+ than from FGS- women (4.7% vs. 1.5%, p = 0.018). The CD14+ cell population decreased significantly in both compartments after anti-schistosomal treatment (p = 0.043). Although the frequency of CD4+ cells did not change after treatment, frequencies of CCR5 expression by CD4+ cells decreased significantly in both compartments (from 3.4% to 0.5% in blood, p = 0.036; and from 42.4% to 5.6% in genital samples, p = 0.025).
  
  
  CONCLUSIONS
  The results support the hypothesis that FGS may increase the risk of HIV acquisition, not only through damage of the mucosal epithelial barrier, but also by affecting HIV target cell populations, and that anti-schistosomal treatment can modify this.
authors.affiliation: Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital (OUH), Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kleppa
authors.affiliation: HIV Pathogenesis Programme, Nelson R Mandela School of Medicine, University of KwaZulu-Natal (UKZN), Durban, South Africa.
authors.forename: Veron
authors.initials: V
authors.lastname: Ramsuran
authors.affiliation: School of Public Health Medicine, Nelson R Mandela School of Medicine, UKZN, Durban, South Africa.
authors.forename: Siphosenkosi
authors.initials: S
authors.lastname: Zulu
authors.affiliation: Aarhus University, Aarhus, Denmark.
authors.forename: Gunn Hege
authors.initials: GH
authors.lastname: Karlsen
authors.affiliation: Emory Vaccine Center, Emory University, Atlanta, Georgia, United States of America.
authors.forename: Alfred
authors.initials: A
authors.lastname: Bere
authors.affiliation: Division of Medical Virology, IDM, University of Cape Town, Cape Town, South Africa.
authors.forename: Jo-Ann S
authors.initials: JA
authors.lastname: Passmore
authors.affiliation: Imperial College, London, United Kingdom.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ndhlovu
authors.affiliation: Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital (OUH), Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Kristine
authors.initials: K
authors.lastname: Lillebø
authors.affiliation: Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital (OUH), Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Sigve D
authors.initials: SD
authors.lastname: Holmen
authors.affiliation: Department of Gynaecology, OUH, Oslo, Norway.
authors.forename: Mathias
authors.initials: M
authors.lastname: Onsrud
authors.affiliation: Research Unit, Sorlandet Hospital, Kristiansand, Norway; Centre for Development Studies, University of Agder, Kristiansand, Norway.
authors.forename: Svein Gunnar
authors.initials: SG
authors.lastname: Gundersen
authors.affiliation: School of Public Health Medicine, Nelson R Mandela School of Medicine, UKZN, Durban, South Africa.
authors.forename: Myra
authors.initials: M
authors.lastname: Taylor
authors.affiliation: Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital (OUH), Oslo, Norway; School of Public Health Medicine, Nelson R Mandela School of Medicine, UKZN, Durban, South Africa.
authors.forename: Eyrun F
authors.initials: EF
authors.lastname: Kjetland
authors.affiliation: HIV Pathogenesis Programme, Nelson R Mandela School of Medicine, University of KwaZulu-Natal (UKZN), Durban, South Africa.
authors.forename: Thumbi
authors.initials: T
authors.lastname: Ndung'u
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology / Q000378:metabolism*; D016022:Case-Control Studies; D060085:Coinfection; D005260:Female; D015870:Gene Expression; D005831:Genital Diseases, Female / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism* / Q000469:parasitology; D005836:Genitalia, Female / Q000276:immunology / Q000378:metabolism / Q000469:parasitology; D006801:Humans; D016130:Immunophenotyping; D009000:Monocytes / Q000187:drug effects / Q000276:immunology / Q000378:metabolism*; D010641:Phenotype; D011223:Praziquantel / Q000494:pharmacology / Q000627:therapeutic use; D019713:Receptors, CCR5 / Q000235:genetics / Q000378:metabolism*; D012548:Schistosoma haematobium; D012552:Schistosomiasis / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism* / Q000469:parasitology; D055815:Young Adult
chemical_list: D019713:Receptors, CCR5; D011223:Praziquantel