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Perera DJ, Koger-Pease C, Paulini K, Daoudi M, Ndao M. Beyond schistosomiasis: unraveling co-infections and altered immunity. Clin Microbiol Rev 2024; 37:e0009823. [PMID: 38319102 PMCID: PMC10938899 DOI: 10.1128/cmr.00098-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
Schistosomiasis is a neglected tropical disease caused by the helminth Schistosoma spp. and has the second highest global impact of all parasites. Schistosoma are transmitted through contact with contaminated fresh water predominantly in Africa, Asia, the Middle East, and South America. Due to the widespread prevalence of Schistosoma, co-infection with other infectious agents is common but often poorly described. Herein, we review recent literature describing the impact of Schistosoma co-infection between species and Schistosoma co-infection with blood-borne protozoa, soil-transmitted helminths, various intestinal protozoa, Mycobacterium, Salmonella, various urinary tract infection-causing agents, and viral pathogens. In each case, disease severity and, of particular interest, the immune landscape, are altered as a consequence of co-infection. Understanding the impact of schistosomiasis co-infections will be important when considering treatment strategies and vaccine development moving forward.
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Affiliation(s)
- Dilhan J. Perera
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Cal Koger-Pease
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Kayla Paulini
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Mohamed Daoudi
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Momar Ndao
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Canada
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Gichuki PM, Kibe L, Mwatele C, Mwangangi J, Mbogo CM. Towards an integrated vector management approach for sustainable control of schistosomiasis and malaria in Mwea, Kirinyaga County, Kenya: Baseline epidemiological and vector results. Heliyon 2023; 9:e20966. [PMID: 37876477 PMCID: PMC10590948 DOI: 10.1016/j.heliyon.2023.e20966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 10/12/2023] [Accepted: 10/12/2023] [Indexed: 10/26/2023] Open
Abstract
Background Vector control is an important approach in the control of most parasitic and vector-borne diseases including malaria, and schistosomiasis. Distribution of these two infections often overlaps and in such areas it's more economically viable to employ an integrated approach in the control of their vectors which largely shares the same breeding ecosystem. We carried out a baseline epidemiological and vector surveys for malaria and schistosomiasis in Mwea, Kirinyaga County, in preparation for the upscaling of integrated vector management (IVM) for the two diseases. Methods This was a repeated cross sectional survey, where mosquito and snails were sampled during dry and wet seasons in three different ecological zones, Kiamaciri, Thiba and Murinduko to identify possible breeding sites. Mosquito larvae were collected using standard dippers, adults using CDC miniature light traps while snail vectors were sampled using standard snail scoops in different breeding habitats. A total of 1200 pupils from 12 primary schools were tested for malaria using rapid diagnostic tests (Malaria Pf/PAN Ag combo). Stool samples were processed using the Kato Katz technique for intestinal schistosomiasis. Results The overall prevalence of intestinal schistosomiasis was 9.08 % (95 % CI: 07.00-11.00), with Kiamaciri zone recording the highest prevalence at 19 % (95%CI: 15.00-23.00) and Murinduko zone the least at 0.17 % (95%CI: 0.00-0.01). Majority of the infections were of light intensity 78.9 % (95%CI: 70.04-86.13). There was no positive malaria case detected in this study. Of the 3208 adult mosquitoes sampled during the dry season, 20.6 % (95 % CI: 19.25-22.08) were Anopheles gambiae s.l while 79.4 % (95 % CI: 77.92-80.75) were culicines. During the wet season, 3378 adult mosquitoes were collected, of which 14.7 % (95 % CI: 13.56-15.98) were Anopheles gambiae s.l and 85.3 % (95 % CI: 84.02-86.44) culicines. Overall, 4085 mosquito larvae were collected during the two seasons, of which, 57.3 % and 42.7 % were anopheles and culicine respectively. Majority of the larvae (85.1 % (95%CI: 84.01-86.10) were collected during the wet season, with only 14.9 % (95%CI: 14.10-16.00) being collected during the dry season. A total of 2292 fresh water vector snails were collected with a majority (69.6 % (95%CI: 68.00-71.10) being Biomphalaria pffeiferi responsible for transmission of intestinal schistosomiasis. Conclusion This study demonstrates that intestinal schistosomiasis is prevalent in Kiamaciri and Thiba zones, and points to the possibility of active transmission of schistosomiasis in Murinduko zone. Malaria vectors were predominantly observed in all sites despite there being no malaria positive case. Culex quinquefaciatus responsible for the spread of several arboviruses was also observed. The presence of these vectors may lead to future disease outbreaks in the area if concerted control initiatives are not undertaken. The disease vectors shared the same breeding sites and thus its economical and feasible to adopt an integrated vector management approach in control efforts for these disease in the study area.
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Affiliation(s)
- Paul M. Gichuki
- Kenya Medical Research Institute (KEMRI), Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Nairobi, P.O BOX 54840-00200 Nairobi, Kenya
- School of Health Sciences, Meru University of Science and Technology, P.O BOX 972-60200 Meru, Kenya
| | - Lydia Kibe
- Kenya Medical Research Institute (KEMRI), Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Nairobi, P.O BOX 54840-00200 Nairobi, Kenya
| | - Cassian Mwatele
- Kenya Medical Research Institute (KEMRI), Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Nairobi, P.O BOX 54840-00200 Nairobi, Kenya
| | - Joseph Mwangangi
- KEMRI-Wellcome Trust Research Programme, Public Health Unit, PO Box 43640 - 00100, Nairobi, Kenya
- Kenya Medical Research Institute (KEMRI), Centre for Geographical Medicine Research-Coast (CGMR-C). P.O Box 230- 80108 Kilifi, Kenya
| | - Charles M. Mbogo
- Kenya Medical Research Institute (KEMRI), Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Nairobi, P.O BOX 54840-00200 Nairobi, Kenya
- KEMRI-Wellcome Trust Research Programme, Public Health Unit, PO Box 43640 - 00100, Nairobi, Kenya
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Tong Y, Tang L, Xia M, Li G, Hu B, Huang J, Wang J, Jiang H, Yin J, Xu N, Chen Y, Jiang Q, Zhou J, Zhou Y. Identifying determinants for the seropositive rate of schistosomiasis in Hunan province, China: A multi-scale geographically weighted regression model. PLoS Negl Trop Dis 2023; 17:e0011466. [PMID: 37440524 DOI: 10.1371/journal.pntd.0011466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Schistosomiasis is of great public health concern with a wide distribution and multiple determinants. Due to the advances in schistosomiasis elimination and the need for precision prevention and control, identifying determinants at a fine scale is urgent and necessary, especially for resource deployment in practice. Our study aimed to identify the determinants for the seropositive rate of schistosomiasis at the village level and to explore their spatial variations in local space. METHODOLOGY The seropositive rates of schistosomiasis were collected from 1714 villages or communities in Human Province, and six spatial regression models including ordinary least squares (OLS), spatial lag model (SLM), spatial error model (SEM), geographically weighted regression (GWR), robust GWR (RGWR) and multiscale GWR (MGWR) were used to fit the data. PRINCIPAL/FINDINGS MGWR was the best-fitting model (R2: 0.821, AICc:2727.092). Overall, the nearest distance from the river had the highest mean negative correlation, followed by proportion of households using well water and the annual average daytime surface temperature. The proportions of unmodified toilets showed the highest mean positive correlation, followed by the snail infested area, and the number of cattle. In spatial variability, the regression coefficients for the nearest distance from the river, annual average daytime surface temperature and the proportion of unmodified toilets were significant in all villages or communities and varied little in local space. The other significant determinants differed substantially in local space and had significance ratios ranging from 41% to 70%, including the number of cattle, the snail infested area and the proportion of households using well water. CONCLUSIONS/SIGNIFICANCE Our study shows that MGWR was well performed for the spatial variability of schistosomiasis in Hunan province. The spatial variability was different for different determinants. The findings for the determinants for the seropositive rate and mapped variability for some key determinants at the village level can be used for developing precision intervention measure for schistosomiasis control.
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Affiliation(s)
- Yixin Tong
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Ling Tang
- Hunan Institute for Schistosomiasis Control, Yueyang, China
| | - Meng Xia
- Hunan Institute for Schistosomiasis Control, Yueyang, China
| | - Guangping Li
- Hunan Institute for Schistosomiasis Control, Yueyang, China
| | - Benjiao Hu
- Hunan Institute for Schistosomiasis Control, Yueyang, China
| | - Junhui Huang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Jiamin Wang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Honglin Jiang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Jiangfan Yin
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Ning Xu
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Qingwu Jiang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Jie Zhou
- Hunan Institute for Schistosomiasis Control, Yueyang, China
| | - Yibiao Zhou
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
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PrayGod G, Filteau S, Range N, Ramaiya K, Jeremiah K, Rehman AM, Krogh-Madsen R, Friis H, Faurholt-Jepsen D. The association of Schistosoma and geohelminth infections with β-cell function and insulin resistance among HIV-infected and HIV-uninfected adults: A cross-sectional study in Tanzania. PLoS One 2022; 17:e0262860. [PMID: 35077485 PMCID: PMC8789133 DOI: 10.1371/journal.pone.0262860] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 01/06/2022] [Indexed: 01/15/2023] Open
Abstract
Objectives Data on the role of helminths on diabetes in Africa are limited. We investigated whether Schistosoma and geohelminth infections are associated with β-cell function and insulin resistance among adults. Methods A cross-sectional study was conducted among adults during 2016–2017. Demography, Schistosoma and geohelminth infections, HIV and insulin data were collected. Insulin during an oral glucose tolerance test (fasting, 30, and 120-min), overall insulin secretion index, insulinogenic index, HOMA-β, and HOMA-IR were main outcome measures for β-cell function and insulin resistance, respectively. Generalized estimating equations and generalized linear models assessed the association of Schistosoma and geohelminth infections with outcome measures separately by HIV status. Outcomes were presented as marginal means with 95% CI. Results Data were obtained for 1718 participants. Schistosoma infection was associated with higher 30-min insulin (24.2 mU/L, 95% CI: 6.9, 41.6) and overall insulin secretion index (13.3 pmol/L/mmol/L; 3.7, 22.9) among HIV-uninfected participants but with lower fasting insulin (-0.9 mU/L; -1.6, -0.2), 120-min insulin (-12.0 mU/L; -18.9, -5.1), and HOMA-IR (-0.3 mmol/L; -0.6, -0.05) among HIV-infected participants not yet on antiretroviral therapy (ART). Among HIV-infected participants not on ART, geohelminth infection was associated with lower fasting insulin (-0.9 mU/L; -1.6, -0.2), 120-min insulin (-9.1 mU/L; -17.3, -1.0), HOMA-β (-8.9 mU/L)/(mmol/L; -15.3, -2.6) and overall insulin release index (-5.1 pmol/L/mmol/L; -10.3, 0.02), although this was marginally significant. There was no association among those on ART. Conclusions Schistosoma infection was associated with higher β-cell function among HIV-uninfected participants whereas Schistosoma and geohelminth infections were associated with reduced β-cell function among HIV-infected participants not on ART.
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Affiliation(s)
- George PrayGod
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
- * E-mail:
| | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Nyagosya Range
- Muhimbili Research Centre, National Institute for Medical Research, Dar es Saalam, Tanzania
| | | | - Kidola Jeremiah
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | - Andrea M. Rehman
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rikke Krogh-Madsen
- Centre for Physical Activity Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Jewell PD, Abraham A, Schmidt V, Buell KG, Bustos JA, Garcia HH, Dixon MA, Walker M, Ngowi BJ, Basáñez MG, Winkler AS. Neurocysticercosis and HIV/AIDS co-infection: A scoping review. Trop Med Int Health 2021; 26:1140-1152. [PMID: 34228854 DOI: 10.1111/tmi.13652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Neurocysticercosis (NCC) and human immunodeficiency virus (HIV) have a high disease burden and are prevalent in overlapping low- and middle-income areas. Yet, treatment guidance for people living with HIV/AIDS (PLWH/A) co-infected with NCC is currently lacking. This study aims to scope the available literature on HIV/AIDS and NCC co-infection, focusing on epidemiology, clinical characteristics, diagnostics and treatment outcomes. METHODS The scoping literature review methodological framework, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. A total of 16,969 records identified through database searching, and 45 additional records from other sources were reduced to 52 included studies after a standardised selection process. RESULTS Two experimental studies, ten observational studies, 23 case series/case reports and 17 reviews or letters were identified. Observational studies demonstrated similar NCC seroprevalence in PLWH/A and their HIV-negative counterparts. Of 29 PLWH/A and NCC co-infection, 17 (59%) suffered from epileptic seizures, 15 (52%) from headaches and 15 (52%) had focal neurological deficits. Eighteen (62%) had viable vesicular cysts, and six (21%) had calcified cysts. Fifteen (52%) were treated with albendazole, of which 11 (73%) responded well to treatment. Five individuals potentially demonstrated an immune-reconstitution inflammatory syndrome after commencing antiretroviral therapy, although this was in the absence of immunological and neuroimaging confirmation. CONCLUSIONS There is a paucity of evidence to guide treatment of PLWH/A and NCC co-infection. There is a pressing need for high-quality studies in this patient group to appropriately inform diagnostic and management guidelines for HIV-positive patients with NCC.
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Affiliation(s)
- Paul D Jewell
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, UK
| | - Annette Abraham
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Community Medicine and Global Health, Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Community Medicine and Global Health, Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Kevin G Buell
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, UK
| | - Javier A Bustos
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru.,Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Hector H Garcia
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru.,Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Matthew A Dixon
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, UK.,Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK.,Schistosomiasis Control Initiative Foundation, London, UK
| | - Martin Walker
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, UK.,Department of Pathobiology and Population Sciences, London Centre for Neglected Tropical Disease Research, Royal Veterinary College, Hatfield, UK
| | - Bernard J Ngowi
- Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania.,College of Health and Allied Sciences, University of Dar es Salaam, Dar es Salaam, Tanzania
| | - Maria-Gloria Basáñez
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, UK.,Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Andrea S Winkler
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Community Medicine and Global Health, Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Wall KM, Nyombayire J, Parker R, Ingabire R, Bizimana J, Mukamuyango J, Mazzei A, Price MA, Unyuzimana MA, Tichacek A, Allen S, Karita E. Etiologies of genital inflammation and ulceration in symptomatic Rwandan men and women responding to radio promotions of free screening and treatment services. PLoS One 2021; 16:e0250044. [PMID: 33878134 PMCID: PMC8057583 DOI: 10.1371/journal.pone.0250044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/30/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The longstanding inadequacies of syndromic management for genital ulceration and inflammation are well-described. The Rwanda National Guidelines for sexually transmitted infection (STI) syndromic management are not yet informed by the local prevalence and correlates of STI etiologies, a component World Health Organization guidelines stress as critical to optimize locally relevant algorithms. METHODS Radio announcements and pharmacists recruited symptomatic patients to seek free STI services in Kigali. Clients who sought services were asked to refer sexual partners and symptomatic friends. Demographic, behavioral risk factor, medical history, and symptom data were collected. Genital exams were performed by trained research nurses and physicians. We conducted phlebotomy for rapid HIV and rapid plasma reagin (RPR) serologies and vaginal pool swab for microscopy of wet preparation to diagnose Trichomonas vaginalis (TV), bacterial vaginosis (BV), and vaginal Candida albicans (VCA). GeneXpert testing for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) were conducted. Here we assess factors associated with diagnosis of NG and CT in men and women. We also explore factors associated with TV, BV and VCA in women. Finally, we describe genital ulcer and RPR results by HIV status, gender, and circumcision in men. RESULTS Among 974 men (with 1013 visits), 20% were positive for CT and 74% were positive for NG. Among 569 women (with 579 visits), 17% were positive for CT and 27% were positive for NG. In multivariate analyses, factors associated with CT in men included younger age, responding to radio advertisements, <17 days since suspected exposure, and not having dysuria. Factors associated with NG in men included not having higher education or full-time employment, <17 days since suspected exposure, not reporting a genital ulcer, and having urethral discharge on physical exam. Factors associated with CT in women included younger age and < = 10 days with symptoms. Factors associated with NG in women included younger age, lower education and lack of full-time employment, sometimes using condoms vs. never, using hormonal vs. non-hormonal contraception, not having genital ulcer or itching, having symptoms < = 10 days, HIV+ status, having BV, endocervical discharge noted on speculum exam, and negative vaginal wet mount for VCA. In multivariate analyses, only reporting >1 partner was associated with BV; being single and RPR+ was associated with TV; and having < = 1 partner in the last month, being pregnant, genital itching, discharge, and being HIV and RPR negative were associated with VCA. Genital ulcers and positive RPR were associated with being HIV+ and lack of circumcision among men. HIV+ women were more likely to be RPR+. In HIV+ men and women, ulcers were more likely to be herpetic rather than syphilitic compared with their HIV- counterparts. CONCLUSIONS Syndromic management guidelines in Rwanda can be improved with consideration of the prevalence of confirmed infections from this study of symptomatic men and women representative of those who would seek care at government health centers. Inclusion of demographic and risk factor measures shown to be predictive of STI and non-STI dysbioses may also increase diagnostic accuracy.
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Affiliation(s)
- Kristin M. Wall
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, Georgia, United States of America
| | - Julien Nyombayire
- Project San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda
| | - Rachel Parker
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, Georgia, United States of America
| | - Rosine Ingabire
- Project San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda
| | - Jean Bizimana
- Project San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda
| | | | - Amelia Mazzei
- Project San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda
| | - Matt A. Price
- IAVI, NY, NY, University of California San Francisco, San Francisco, CA, United States of America
| | | | - Amanda Tichacek
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, Georgia, United States of America
| | - Susan Allen
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, Georgia, United States of America
| | - Etienne Karita
- Project San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda
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Case Study: Schistosomiasis of the Endocervical Canal, A Rarely Reported Localization. Int J Gynecol Pathol 2021; 39:301-304. [PMID: 32267657 DOI: 10.1097/pgp.0000000000000610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
With a challenging diagnosis, schistosomiasis is a major public health issue worldwide, particularly in low-resource countries. The presence of Schistosoma ova in the female genital tract is a common finding, which may engender considerable suffering among women of child-bearing age. We report the asymptomatic case of endocervical schistosomiasis without visible exocervical lesions in a 41-yr-old Malagasy woman with human papillomavirus-positive status detected during a cervical cancer screening campaign in Andilampanahy, Madagascar. Schistosomiasis involving only the endocervical canal is rarely reported and can be diagnosed histologically with endocervical brushing, which therefore represents a minimally invasive and well-tolerated tool for disease detection.
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Mehta SD, Okal D, Otieno F, Green SJ, Nordgren RK, Huibner S, Bailey RC, Bhaumik DK, Landay A, Kaul R. Schistosomiasis is associated with rectal mucosal inflammation among Kenyan men who have sex with men. Int J STD AIDS 2021; 32:694-703. [PMID: 33533314 DOI: 10.1177/0956462420985973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Schistosoma mansoni infection is hyperendemic in Lake Victoria communities and associated with cervicovaginal immune alterations and HIV acquisition. We assessed the hypothesis that schistosomiasis correlates with greater rectal inflammation in men who have sex with men (MSM) in Kisumu, Kenya. Methods: In this cross-sectional study of 38 HIV-negative MSM aged 18-35 years, schistosomiasis was diagnosed by urine circulating cathodic antigen (CCA). Microbiome was assessed in rectal swabs by 16S rRNA gene amplicon sequencing, and rectal inflammation by quartile normalized summative score of inflammatory cytokines (IL-1α, IL-1β, IL-8, and TNF-α). Elastic net (EN) regression identified taxa associated with inflammation. Multivariable linear regression estimated the association between inflammation score and schistosomiasis and bacteria identified in EN. Results: Most men were CCA positive (24/38; 63%), and median rectal inflammation score was significantly higher in these participants (11 vs. 8, p = 0.04). In multivariable regression, CCA-positive men had 2.85-point greater inflammation score (p = 0.009). The relative abundance of Succinivibrio (coefficient = -1.13, p = 0.002) and Pseudomonas (coefficient = -1.04, p = 0.001) were negatively associated with inflammation. Discussion: CCA positivity was associated with rectal mucosal inflammation, controlling for rectal microbiome composition. Given its high prevalence and contribution to inflammation, schistosomiasis may have important implications for HIV transmission in this vulnerable population.
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Affiliation(s)
- Supriya D Mehta
- Division of Epidemiology & Biostatistics, 14681University of Illinois at Chicago School of Public Health, Chicago, USA
| | - Duncan Okal
- Nyanza Reproductive Health Society, Kisumu, Kenya
| | | | - Stefan J Green
- Sequencing Core, Research Resources Center, 14681University of Illinois at Chicago, Chicago, USA
| | - Rachel K Nordgren
- Division of Epidemiology & Biostatistics, 14681University of Illinois at Chicago School of Public Health, Chicago, USA
| | - Sanja Huibner
- Division of Infectious Diseases, University of Toronto School of Medicine, Toronto, Canada
| | - Robert C Bailey
- Division of Epidemiology & Biostatistics, 14681University of Illinois at Chicago School of Public Health, Chicago, USA
| | - Dulal K Bhaumik
- Division of Epidemiology & Biostatistics, 14681University of Illinois at Chicago School of Public Health, Chicago, USA
| | - Alan Landay
- Department of Internal Medicine, 2468Rush University, Chicago, USA
| | - Rupert Kaul
- Division of Infectious Diseases, University of Toronto School of Medicine, Toronto, Canada
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9
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McLaughlin TA, Nizam A, Hayara FO, Ouma GS, Campbell A, Khayumbi J, Ongalo J, Ouma SG, Shah NS, Altman JD, Kaushal D, Rengarajan J, Ernst JD, Blumberg HM, Waller LA, Gandhi NR, Day CL, Benkeser D. Schistosoma mansoni Infection Is Associated With a Higher Probability of Tuberculosis Disease in HIV-Infected Adults in Kenya. J Acquir Immune Defic Syndr 2021; 86:157-163. [PMID: 33074856 PMCID: PMC8284023 DOI: 10.1097/qai.0000000000002536] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/28/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Helminth infections can modulate immunity to Mycobacterium tuberculosis (Mtb). However, the effect of helminths, including Schistosoma mansoni (SM), on Mtb infection outcomes is less clear. Furthermore, HIV is a known risk factor for tuberculosis (TB) disease and has been implicated in SM pathogenesis. Therefore, it is important to evaluate whether HIV modifies the association between SM and Mtb infection. SETTING HIV-infected and HIV-uninfected adults were enrolled in Kisumu County, Kenya, between 2014 and 2017 and categorized into 3 groups based on Mtb infection status: Mtb-uninfected healthy controls, latent TB infection (LTBI), and active TB disease. Participants were subsequently evaluated for infection with SM. METHODS We used targeted minimum loss estimation and super learning to estimate a covariate-adjusted association between SM and Mtb infection outcomes, defined as the probability of being Mtb-uninfected healthy controls, LTBI, or TB. HIV status was evaluated as an effect modifier of this association. RESULTS SM was not associated with differences in baseline demographic or clinical features of participants in this study, nor with additional parasitic infections. Covariate-adjusted analyses indicated that infection with SM was associated with a 4% higher estimated proportion of active TB cases in HIV-uninfected individuals and a 14% higher estimated proportion of active TB cases in HIV-infected individuals. There were no differences in estimated proportions of LTBI cases. CONCLUSIONS We provide evidence that SM infection is associated with a higher probability of active TB disease, particularly in HIV-infected individuals.
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Affiliation(s)
| | - Azhar Nizam
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | | | - Gregory Sadat Ouma
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Angela Campbell
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Jeremiah Khayumbi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Joshua Ongalo
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Samuel Gurrion Ouma
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - N. Sarita Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - John D. Altman
- Emory Vaccine Center, Emory University, Atlanta, GA USA
- Department of Microbiology & Immunology, Emory University School of Medicine, Atlanta, GA USA
| | - Deepak Kaushal
- Southwest National Primate Research Center, Texas Biomedical Research Center, San Antonio, TX
| | - Jyothi Rengarajan
- Emory Vaccine Center, Emory University, Atlanta, GA USA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA USA
| | - Joel D. Ernst
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, CA USA
| | - Henry M. Blumberg
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA USA
| | - Lance A. Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Neel R. Gandhi
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA USA
| | - Cheryl L. Day
- Emory Vaccine Center, Emory University, Atlanta, GA USA
- Department of Microbiology & Immunology, Emory University School of Medicine, Atlanta, GA USA
| | - David Benkeser
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA USA
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10
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Patel P, Rose CE, Kjetland EF, Downs JA, Mbabazi PS, Sabin K, Chege W, Watts DH, Secor WE. Association of schistosomiasis and HIV infections: A systematic review and meta-analysis. Int J Infect Dis 2020; 102:544-553. [PMID: 33157296 PMCID: PMC8883428 DOI: 10.1016/j.ijid.2020.10.088] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/25/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023] Open
Abstract
Background: Female genital schistosomiasis (FGS) affects up to 56 million women in sub-Saharan Africa and may increase risk of HIV infection. Methods: To assess the association of schistosomiasis with HIV infection, peer-reviewed literature published until 31 December 2018 was examined and a pooled estimate for the odds ratio was generated using Bayesian random effects models. Results: Of the 364 abstracts that were identified, 26 were included in the summary. Eight reported odds ratios of the association between schistosomiasis and HIV; one reported a transmission hazard ratio of 1.8 (95% CI, 1.2–2.6) among women and 1.4 (95% CI, 1.0–1.9) among men; 11 described the prevalence of schistosomiasis among HIV-positive people (range, 1.5–36.6%); and six reported the prevalence of HIV among people with schistosomiasis (range, 5.8–57.3%). Six studies were selected for quantitative analysis. The pooled estimate for the odds ratio of HIV among people with schistosomiasis was 2.3 (95% CI, 1.2–4.3). Conclusions: A significant association of schistosomiasis with HIV was found. However, a specific summary estimate for FGS could not be generated. A research agenda was provided to determine the effect of FGS on HIV infection. The WHO’s policy on mass drug administration for schistosomiasis may prevent HIV.
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Affiliation(s)
- Pragna Patel
- Division of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Charles E Rose
- Deputy Director for Non-Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eyrun F Kjetland
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, Oslo, Norway; Discipline of Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Jennifer A Downs
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Pamela Sabina Mbabazi
- World Health Organization, Department of Control of Neglected Tropical Diseases, Geneva, Switzerland
| | | | - Wairimu Chege
- National Institutes of Health, National Institutes of Allergy and Infectious Diseases, Division of AIDS, Rockville, MD, USA
| | - D Heather Watts
- Office of the Global AIDS Coordinator, Department of State, Washington, DC, USA
| | - W Evan Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
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11
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Akumadu BO, Pandian R, Olfsen J, Worth R, Thulo M, Mentor T, Fanucchi S, Sayed Y, Dirr HW, Achilonu I. Molecular basis of inhibition of Schistosoma japonicum glutathione transferase by ellagic acid: Insights into biophysical and structural studies. Mol Biochem Parasitol 2020; 240:111319. [PMID: 32961204 DOI: 10.1016/j.molbiopara.2020.111319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/09/2020] [Accepted: 08/13/2020] [Indexed: 02/06/2023]
Abstract
Schistosoma japonicum glutathione transferase (Sj26GST), an enzyme central to detoxification of electrophilic compounds in the parasite, is upregulated in response to drug treatment. Therefore, Sj26GST may serve as a potential therapeutic target for the treatment of schistosomiasis. Herewith, we describe the structural basis of inhibition of Sj26GST by ellagic acid (EA). Using 1-chloro-2,4-dinitrobenzene and reduced glutathione (GSH) as Sj26GST substrates, EA was shown to inhibit Sj26GST activity by 66 % with an IC50 of 2.4 μM. Fluorescence spectroscopy showed that EA altered the polarity of the environment of intrinsic tryptophan and that EA decreased (in a dose-dependent manner) the interaction between Sj26GST and 8-Anilino-1-naphthalenesulfonate (ANS), which is a known GST H-site ligand. Thermodynamic studies indicated that the interaction between Sj26GST and EA is spontaneous (ΔG = -29.88 ± 0.07 kJ/mol), enthalpically-driven (ΔH = -9.48 ± 0.42 kJ/mol) with a favourable entropic change (ΔS = 20.40 ± 0.08 kJ/mol/K), and with a stoichiometry of four EA molecules bound per Sj26GST dimer. The 1.53 Å-resolution Sj26GST crystal structure (P 21 21 21 space group) complexed with GSH and EA shows that EA binds primarily at the dimer interface, stabilised largely by Van der Waal forces and H-bonding. Besides, EA bound near the H-site and less than 3.5 Å from the ε-NH2 of the γ-glutamyl moiety of GSH, in each subunit.
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Affiliation(s)
- Blessing O Akumadu
- Protein Structure-Function Research Unit, School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Ramesh Pandian
- Protein Structure-Function Research Unit, School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Jessica Olfsen
- Protein Structure-Function Research Unit, School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Roland Worth
- Protein Structure-Function Research Unit, School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Monare Thulo
- Protein Structure-Function Research Unit, School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Tshireletso Mentor
- Protein Structure-Function Research Unit, School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Sylvia Fanucchi
- Protein Structure-Function Research Unit, School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Yasien Sayed
- Protein Structure-Function Research Unit, School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Heini W Dirr
- Protein Structure-Function Research Unit, School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Ikechukwu Achilonu
- Protein Structure-Function Research Unit, School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg 2050, South Africa.
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12
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Engels D, Hotez PJ, Ducker C, Gyapong M, Bustinduy AL, Secor WE, Harrison W, Theobald S, Thomson R, Gamba V, Masong MC, Lammie P, Govender K, Mbabazi PS, Malecela MN. Integration of prevention and control measures for female genital schistosomiasis, HIV and cervical cancer. Bull World Health Organ 2020; 98:615-624. [PMID: 33012861 PMCID: PMC7463188 DOI: 10.2471/blt.20.252270] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 11/27/2022] Open
Abstract
Female genital schistosomiasis as a result of chronic infection with Schistosoma haematobium (commonly known as bilharzia) continues to be largely ignored by national and global health policy-makers. International attention for large-scale action against the disease focuses on whether it is a risk factor for the transmission of human immunodeficiency virus (HIV). Yet female genital schistosomiasis itself is linked to pain, bleeding and sub- or infertility, leading to social stigma, and is a common issue for women in schistosomiasis-endemic areas in sub-Saharan Africa. The disease should therefore be recognized as another component of a comprehensive health and human rights agenda for women and girls in Africa, alongside HIV and cervical cancer. Each of these three diseases has a targeted and proven preventive intervention: antiretroviral therapy and pre-exposure prophylaxis for HIV; human papilloma virus vaccine for cervical cancer; and praziquantel treatment for female genital schistosomiasis. We discuss how female genital schistosomiasis control can be integrated with HIV and cervical cancer care. Such a programme will be part of a broader framework of sexual and reproductive health and rights, women's empowerment and social justice in Africa. Integrated approaches that join up multiple public health programmes have the potential to expand or create opportunities to reach more girls and women throughout their life course. We outline a pragmatic operational research agenda that has the potential to optimize joint implementation of a package of measures responding to the specific needs of girls and women.
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Affiliation(s)
- Dirk Engels
- Uniting to Combat NTDs, Chemin de la Gouille 8, 1291 Commugny, Switzerland
| | - Peter J Hotez
- National School of Tropical Medicine, Baylor College of Medicine, Houston, United States of America (USA)
| | | | - Margaret Gyapong
- Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Amaya L Bustinduy
- Clinical Research, London School of Hygiene and Tropical Medicine, London, England
| | - William E Secor
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Sally Theobald
- International Public Health, Liverpool School of Tropical Medicine, Liverpool, England
| | - Rachael Thomson
- Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, England
| | - Victoria Gamba
- Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - Makia C Masong
- Catholic University of Central Africa, Yaoundé, Cameroon
| | - Patrick Lammie
- Neglected Tropical Diseases Support Center, The Task Force for Global Health, Decatur, USA
| | - Kreeneshni Govender
- Human Rights and Gender, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland
| | - Pamela S Mbabazi
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Mwelecele N Malecela
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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13
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Mohanlal R, Reddy DL. Spectrum of HIV-associated infectious diseases: A case series through the eyes of the histopathologist. South Afr J HIV Med 2020; 21:1087. [PMID: 32670628 PMCID: PMC7343954 DOI: 10.4102/sajhivmed.v21i1.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/23/2020] [Indexed: 11/11/2022] Open
Abstract
Background Human immunodeficiency virus (HIV) infection increases the risk of infection by a host of other opportunistic pathogens. The clinical presentations of these co-infections in immunocompromised patients are often atypical; therefore diagnosis is delayed in the absence of investigations such as tissue biopsy. Infection may involve sites that are difficult to access for biopsy and, as a consequence, there is limited diagnostic tissue available for analysis. The histopathologist, aided by ancillary tests, is relied upon to make a timeous and accurate diagnosis. Objectives To illustrate key histological features of HIV-associated infectious diseases encountered in a histopathology laboratory and to highlight, with the aid of literature, the relevance of histopathology in diagnosis. Method A retrospective descriptive case series of biopsies histologically diagnosed with HIV-associated infectious diseases over four years (2015–2019) was performed at the Chris Hani Baragwanath Academic Hospital National Health Laboratory Services Histopathology department. These cases have been photographed to illustrate microscopic aspects and will be accompanied by a literature review of opportunistic infections in the context of HIV infection. Results This article highlights aspects of fungal, parasitic, viral and selected bacterial infections of people living with HIV for whom the histopathological examination of tissue was an essential component of the clinical diagnosis. Histological features are noted on routine slides and accompanied by diagnostic features revealed with histochemical and immunohistochemical stains. Conclusion Medical practitioners working in areas of high HIV endemicity should be familiar with the variety of infectious diseases that are encountered and with the diagnostic importance of the histopathologist in clinical management.
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Affiliation(s)
- Reena Mohanlal
- Department of Anatomical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,National Health Laboratory Services, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Denasha L Reddy
- Division of Infectious Diseases, Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
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14
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Furch BD, Koethe JR, Kayamba V, Heimburger DC, Kelly P. Interactions of Schistosoma and HIV in Sub-Saharan Africa: A Systematic Review. Am J Trop Med Hyg 2020; 102:711-718. [PMID: 32043458 DOI: 10.4269/ajtmh.19-0494] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Schistosomiasis is an acute and chronic parasitic disease caused by blood flukes of the genus Schistosoma. More than 220 million people worldwide were estimated to have active schistosomiasis in 2017, 90% of whom live on the African continent, but only 102 million were reported to have received treatment. Africa is also disproportionately burdened by HIV, with an estimated 26 million people living with HIV in 2017. Given these overlapping epidemics, we conducted a systematic review to ascertain the contribution of schistosomes to HIV acquisition risk, the contribution of HIV to schistosome acquisition, the impact of HIV on schistosomiasis-related morbidity, the impact of schistosomes on HIV disease progression and immune response, the impact of HIV on the efficacy of praziquantel treatment, and the impact of HIV on egg shedding. We reviewed studies of people living in sub-Saharan Africa coinfected with HIV and Schistosoma spp. between January 1996 and July 2018. We found that 1) infection with Schistosoma haematobium increases the risk of HIV acquisition, 2) there is currently a lack of data on whether HIV infection increases the risk of Schistosoma acquisition, 3a) HIV coinfection was not an accelerating factor for adverse Schistosoma outcomes, 3b) schistosomiasis may be an important contributor to immune activation in HIV coinfected people, 4) praziquantel use in coinfected people may improve immune reconstitution on antiretroviral therapy for HIV, and 5) there is evidence that HIV infection reduces egg excretion in individuals infected with Schistosoma mansoni.
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Affiliation(s)
- Briana D Furch
- Tropical Gastroenterology & Nutrition Group, University of Zambia School of Medicine, Lusaka, Zambia.,Vanderbilt University Medical Center, Nashville, Tennessee
| | - John R Koethe
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Violet Kayamba
- Tropical Gastroenterology & Nutrition Group, University of Zambia School of Medicine, Lusaka, Zambia
| | - Douglas C Heimburger
- University Teaching Hospital, University of Zambia, Lusaka, Zambia.,Vanderbilt University Medical Center, Nashville, Tennessee
| | - Paul Kelly
- Blizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, United Kingdom.,Tropical Gastroenterology & Nutrition Group, University of Zambia School of Medicine, Lusaka, Zambia
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15
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Cheng G, Li X, Qin F, Xu R, Zhang Y, Liu J, Gu S, Jin Y. Functional analysis of the Frzb2 gene in Schistosoma japonicum. Vet Res 2019; 50:108. [PMID: 31829289 PMCID: PMC6907234 DOI: 10.1186/s13567-019-0716-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/09/2019] [Indexed: 02/06/2023] Open
Abstract
Schistosomiasis is a globally important helminthic disease of humans and animals, and it is the second most common parasitic disease after malaria. Eggs produced by mature females are responsible for the disease’s occurrence and spread. Frzb2, a secreted frizzled-related protein, can inhibit Wnt signalling by competitive binding to the specific frizzled protein receptor. In this study, the complete gene sequence of SjFrzb2 was obtained by using 3′-rapid amplification of cDNA ends technology. SjFrzb2 transcript levels at different stages of S. japonicum maturation were evaluated by quantitative real-time RT-PCR analysis. SjFrzb2 was expressed at all developmental stages examined and exhibited the highest transcription level in 7-day-old worms, then gradually decreased during the growth and developmental stages to reach the lowest level at 18 days post-infection. SjFrzb2 gene expression was higher in female worms than in male worms and was significantly higher in female worms from a single-sex infection than in female worms from a bisexual infection. The functions of SjFrzb2 were explored via a small interfering RNA-based gene silencing approach and the soaking method. The results showed that SjFrzb2 gene knockdown impaired the growth and development of S. japonicum in mice, affecting not only the survival and morphological structure of the worms but also their reproductive ability and the viability of the produced eggs. Collectively, these observations imply that Frzb2 may be a novel target for the development of immuno- and/or small molecule-based therapeutics to control schistosomiasis fecundity and transmission.
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Affiliation(s)
- Guifeng Cheng
- College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, Shanxi, China.,Key Laboratory of Animal Parasitology, Ministry of Agriculture of China, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China
| | - Xiaochun Li
- Key Laboratory of Animal Parasitology, Ministry of Agriculture of China, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China.,College of Life Sciences, Shanghai Normal University, Shanghai, China
| | - Fanglin Qin
- Key Laboratory of Animal Parasitology, Ministry of Agriculture of China, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China.,College of Life Sciences, Shanghai Normal University, Shanghai, China
| | - Rong Xu
- College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, Shanxi, China.,Key Laboratory of Animal Parasitology, Ministry of Agriculture of China, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China
| | - Yuanyuan Zhang
- College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, Shanxi, China.,Key Laboratory of Animal Parasitology, Ministry of Agriculture of China, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China
| | - Jinming Liu
- Key Laboratory of Animal Parasitology, Ministry of Agriculture of China, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China
| | - Shaopeng Gu
- College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, Shanxi, China.
| | - Yamei Jin
- Key Laboratory of Animal Parasitology, Ministry of Agriculture of China, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China.
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16
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Clark EH, Serpa JA. Tissue Parasites in HIV Infection. Curr Infect Dis Rep 2019; 21:49. [PMID: 31734888 DOI: 10.1007/s11908-019-0703-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss the current knowledge of HIV and tissue parasite co-infection in the context of transmission enhancement, clinical characteristics, treatment, relapse, and clinical outcomes. RECENT FINDINGS The pathophysiology and clinical sequelae of tissue parasites in people living with HIV (PLWH) have been well described for only a handful of organisms, primarily protozoa such as malaria and leishmaniasis. Available published data indicate that the interactions between HIV and tissue parasites are highly variable depending on the infecting organism and the degree of host immunosuppression. Some tissue parasites, such as Schistosoma species, are known to facilitate the transmission of HIV. Conversely, uncontrolled HIV infection can lead to the earlier and more severe presentation of a variety of tissue parasites and can make treatment more challenging. Although much investigation remains to be done to better understand the interactions between consequences of HIV and tissue parasite co-infection, it is important to disseminate the current knowledge on this topic to health care providers in order to prevent, treat, and control infections in PLWH.
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Affiliation(s)
- Eva H Clark
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA. .,Houston HSR&D Center for Innovations in Quality, Effectiveness and Safety (IQuEST), Baylor College of Medicine, Michael E. DeBakey VA Medical Center, 2450 Holcombe Blvd., Suite 01Y, Houston, TX, 77021, USA.
| | - Jose A Serpa
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA
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17
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Clark E, Serpa JA. Tropical Diseases in HIV. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2019. [DOI: 10.1007/s40506-019-00194-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Blanton RE. Population Structure and Dynamics of Helminthic Infection: Schistosomiasis. Microbiol Spectr 2019; 7:10.1128/microbiolspec.ame-0009-2019. [PMID: 31325285 PMCID: PMC6650164 DOI: 10.1128/microbiolspec.ame-0009-2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Indexed: 11/20/2022] Open
Abstract
While disease and outbreaks are mainly clonal for bacteria and other asexually reproducing organisms, sexual reproduction in schistosomes and other helminths usually results in unique individuals. For sexually reproducing organisms, the traits conserved in clones will instead be conserved in the group of organisms that tends to breed together, the population. While the same tools are applied to characterize DNA, how results are interpreted can be quite different at times (see another article in this collection, http://www.asmscience.org/content/journal/microbiolspec/10.1128/microbiolspec.AME-0002-2018). It is difficult to know what the real effect any control program has on the parasite population without assessing the health of this population, how they respond to the control measure, and how they recover, if they do. This review, part of the Microbiology Spectrum Curated Collection: Advances in Molecular Epidemiology of Infectious Diseases, concentrates on one approach using pooled samples to study schistosome populations and shows how this and other approaches have contributed to our understanding of this parasite family's biology and epidemiology. *This article is part of a curated collection.
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Affiliation(s)
- Ronald E Blanton
- Center for Global Health and Diseases, Department of Pathology, Case Western Reserve University, Cleveland, OH 44120
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19
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Colombe S, Beard J, Mtenga B, Lutonja P, Mngara J, de Dood CJ, van Dam GJ, Corstjens PLAM, Kalluvya S, Urassa M, Todd J, Downs JA. HIV-seroconversion among HIV-1 serodiscordant married couples in Tanzania: a cohort study. BMC Infect Dis 2019; 19:518. [PMID: 31195994 PMCID: PMC6567663 DOI: 10.1186/s12879-019-4151-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/31/2019] [Indexed: 01/20/2023] Open
Abstract
Background Heterosexual transmission is the main driver of the HIV epidemic in Tanzania. Only one estimate of the incidence rate of intra-marital HIV seroconversion in Tanzania has been reported and was derived from data collected between 1991 and 1995. Moreover, little is known about the specific risk factors for intra-marital seroconversion in Tanzania. Improved evidence around factors that increase the risk of HIV transmission to a serodiscordant spouse is needed to develop and improve evidence-based interventions. We sought to investigate the rate of intra-marital HIV seroconversion among HIV sero-discordant couples in Tanzania as well as its associated risk factors. Methods We identified all HIV positive individuals in the TAZAMA HIV-serosurvey cohort and followed up their serodiscordant spouse from 2006 to 2016. The rate of seroconversion was analyzed by survival analysis using non-parametric regressions with exponential distribution. Results We found 105 serodiscordant couples, 14 of which had a seroconverting spouse. The overall HIV-1 incidence rate among spouses of people with HIV-1 infection was 38.0 per 1000 person/years [22.5–64.1]. Notably, the HIV-1 incidence rate among HIV-1 seronegative male spouses was 6.7[0.9–47.5] per 1000 person/years, compared to 59.3 [34.4–102.1] per 1000 person/years among female spouses. Sex of the serodiscordant spouse was the only significant variable, even after adjusting for other variables (Hazard rate = 8.86[1.16–67.70], p = 0.036). Conclusions Our study suggests that rates of HIV-1 seroconversion of sero-discordant partners are much higher within marriage than in the general population in Tanzania. The major risk factor for HIV-1 seroconversion is sex of the serodiscordant spouse, with female spouses being at very high risk of acquiring HIV infection. This suggests that future programs that target serodiscordant couples could be a novel and effective means of preventing HIV-1 transmission in Tanzania.
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Affiliation(s)
- Soledad Colombe
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, 402 East 67th Street, 2nd Floor, New York, NY, 10065, USA.
| | - James Beard
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Baltazar Mtenga
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Peter Lutonja
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Julius Mngara
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Claudia J de Dood
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Paul L A M Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | - Samuel Kalluvya
- Department of Medicine, Bugando Medical Centre, Mwanza, Tanzania
| | - Mark Urassa
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Jim Todd
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.,National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Jennifer A Downs
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, 402 East 67th Street, 2nd Floor, New York, NY, 10065, USA.,Department of Medicine, Bugando Medical Centre, Mwanza, Tanzania
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20
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Kulinkina AV, Kosinski KC, Adjei MN, Osabutey D, Gyamfi BO, Biritwum NK, Bosompem KM, Naumova EN. Contextualizing Schistosoma haematobium transmission in Ghana: Assessment of diagnostic techniques and individual and community water-related risk factors. Acta Trop 2019; 194:195-203. [PMID: 30871989 DOI: 10.1016/j.actatropica.2019.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 02/23/2019] [Accepted: 03/10/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The study assessed associations between Schistosoma haematobium infection (presence of parasite eggs in urine or hematuria) and self-reported metrics (macrohematuria, fetching surface water, or swimming) to evaluate their performance as proxies of infection in presence of regular preventive chemotherapy. It also examined community water characteristics (safe water access, surface water access, and groundwater quality) to provide context for schistosomiasis transmission in different types of communities and propose interventions. METHODS Logistic regression was used to assess the associations between the various measured and self-reported metrics in a sample of 897 primary school children in 30 rural Ghanaian communities. Logistic regression was also used to assess associations between community water characteristics, self-reported water-related behaviors and S. haematobium infection. Communities were subsequently categorized as candidates for three types of interventions: provision of additional safe water sources, provision of groundwater treatment, and health education about water-related disease risk, depending on their water profile. RESULTS Microhematuria presence measured with a reagent strip was a good proxy of eggs in urine at individual (Kendall's τb = 0.88, p < 0.001) and at school-aggregated (Spearman's rs = 0.96, p < 0.001) levels. Self-reported macrohematuria and swimming were significantly associated (p < 0.05) with egg presence, but self-reported fetching was not. Of the community water characteristics, greater surface water access and presence of groundwater quality problems were significantly associated with increased likelihood of fetching, swimming, and S. haematobium infection. Access to improved water sources did not exhibit an association with any of these outcomes. CONCLUSIONS The study illustrates that in presence of regular school-based treatment with praziquantel, microhematuria assessed via reagent strips remains an adequate proxy for S. haematobium infection in primary schoolchildren. Community water profiles, in combination with self-reported water-related behaviors, can help elucidate reasons for some endemic communities continuing to experience ongoing transmission and tailor interventions to these local contexts to achieve sustainable control.
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Affiliation(s)
| | | | | | - Dickson Osabutey
- University of Ghana, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | - Bernard O Gyamfi
- University College of Agriculture and Environmental Studies, Bunso, Ghana
| | | | - Kwabena M Bosompem
- Community Directed Development Foundation, Accra, Ghana; University of Ghana, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | - Elena N Naumova
- Tufts University School of Engineering, Medford, MA, USA; Tufts University, Friedman School of Nutrition Science and Policy, Boston, MA, USA
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21
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Yegorov S, Joag V, Galiwango RM, Good SV, Mpendo J, Tannich E, Boggild AK, Kiwanuka N, Bagaya BS, Kaul R. Schistosoma mansoni treatment reduces HIV entry into cervical CD4+ T cells and induces IFN-I pathways. Nat Commun 2019; 10:2296. [PMID: 31127086 PMCID: PMC6534541 DOI: 10.1038/s41467-019-09900-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 04/02/2019] [Indexed: 01/21/2023] Open
Abstract
Schistosoma mansoni (Sm) infection has been linked with an increased risk of HIV acquisition in women. Therefore, defining the mechanism(s) by which Sm alters HIV susceptibility might lead to new HIV prevention strategies. Here, we analyze the impact of standard Sm therapy in HIV-uninfected Sm+ Ugandan adult women on genital HIV susceptibility and mucosal and systemic immunology. Schistosomiasis treatment induces a profound reduction of HIV entry into cervical and blood CD4+ T cells that is sustained for up to two months, despite transient systemic and mucosal immune activation and elevated genital IL-1α levels. Genital IFN-α2a levels are also elevated post-treatment, and IFN-α2a blocks HIV entry into primary CD4+ T cells ex vivo. Transcriptomic analysis of blood mononuclear cells post-Sm treatment shows IFN-I pathway up-regulation and partial reversal of Sm-dysregulated interferon signaling. These findings indicate that Sm therapy may reduce HIV susceptibility for women with Sm infection, potentially through de-repression of IFN-I pathways.
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Affiliation(s)
- Sergey Yegorov
- Departments of Immunology and Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada. .,Department of Science Education, Faculty of Education and Humanities, Suleyman Demirel University, 1/1 Abylai Khan Street, Kaskelen, Almaty, 040900, Kazakhstan.
| | - Vineet Joag
- Departments of Immunology and Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.,Department of Microbiology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Ronald M Galiwango
- Departments of Immunology and Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Sara V Good
- Genetics & Genome Biology, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay St., Toronto, ON, M5G 0A4, Canada.,Community Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg, MB, R3E 0W2, Canada
| | - Juliet Mpendo
- Uganda Virus Research Institute -International AIDS Vaccine Initiative HIV Vaccine Program, 51/59 Nakiwogo Rd, P.O.Box 49, Entebbe, Uganda
| | - Egbert Tannich
- Bernhard Nocht Institute for Tropical Medicine, National Reference Centre for Tropical Pathogens, Bernhard-Nocht-Str. 74, 20359, Hamburg, Germany
| | - Andrea K Boggild
- Department of Medicine, University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada.,Public Health Ontario Laboratories, 661 University Ave, Toronto, ON, M5G 1M1, Canada
| | - Noah Kiwanuka
- Uganda Virus Research Institute -International AIDS Vaccine Initiative HIV Vaccine Program, 51/59 Nakiwogo Rd, P.O.Box 49, Entebbe, Uganda.,Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Bernard S Bagaya
- Uganda Virus Research Institute -International AIDS Vaccine Initiative HIV Vaccine Program, 51/59 Nakiwogo Rd, P.O.Box 49, Entebbe, Uganda.,Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Rupert Kaul
- Departments of Immunology and Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.,Department of Medicine, University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada
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Impact of Paracoccidioides brasiliensis Coinfection on the Evolution of Schistosoma mansoni-Induced Granulomatous Liver Injury in Mice. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8319465. [PMID: 31019973 PMCID: PMC6451801 DOI: 10.1155/2019/8319465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 02/11/2019] [Accepted: 03/03/2019] [Indexed: 01/21/2023]
Abstract
The pathogens Schistosoma mansoni and Paracoccidioides brasiliensis share common geographic areas, determining infectious diseases with high mortality rates worldwide. Histopathological and immunological changes induced by each pathogen are well understood; however, the host responses to S. mansoni and P. brasiliensis coinfection are still unknown. Thus, we investigated liver damage and cytokines production in a murine model acutely and chronically coinfected with these pathogens. Fourty male Swiss mice were infected with S. mansoni and P. brasiliensis alone or coinfected. The animals were euthanized with 50 (acute infection) and 120 (chronic infection) days of infection. All infected animals exhibited liver inflammation. Intense granulomatous inflammation was detected in animals infected with S. mansoni alone and those coinfected. Productive and involutive granulomas were clearly observed in acute and chronic infections, respectively. Granuloma size was reduced in the acute phase and increased in the chronic phase of S. mansoni and P. brasiliensis coinfection, compared with animals infected only with S. mansoni. In the chronic phase of infection, the granulomatous inflammation in coinfected animals was characterized by intense neutrophils accumulation and reduced eosinophils number. IFN-γ, IL-2, IL-4, and IL-5 circulating levels were increased in all infected groups. Coinfected animals presented attenuated IFN-γ and IL-4 production in the acute and chronic infections. Taken together, our findings indicate that coinfected animals exhibited a differential modulation of granulomatous inflammation during the acute and chronic phases of infection, which was potentially associated with a divergent profile of cytokines production and migration of neutrophils and eosinophils in response to S. mansoni and P. brasiliensis antigenic stimulation.
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Maju M, Sharma A, Beeram A, Ostrach B. A colonial legacy of HIV/AIDS, NTD, and STI super-syndemics: Eugenicist foreign aid and intertwined health burdens in Nigeria. Glob Public Health 2019; 14:1221-1240. [PMID: 30829113 DOI: 10.1080/17441692.2019.1582683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Syndemics theory has been applied to the structurally shaped, biologically facilitated co-occurrence of HIV/AIDS with Neglected Tropical Diseases (NTDs) and with sexually transmitted infections (STIs). The biological and social pathways of interaction between all three ailments have not yet been analysed together. The effects of these diseases are often exacerbated by structural factors including access to care and socioeconomic status. We explore the interrelated biological pathways and structural factors that have further heightened the risk for HIV/AIDS, NTDs, and STIs. Furthermore, we argue women in rural areas are at an increased risk for all three diseases due to biological and social factors including increased distance to quality care and lower reproductive autonomy. This paper integrates the established syndemics of HIV/NTDs and HIV/STIs within the historical and modern contexts of colonisation and neo-colonisation in Nigeria. We explore the effects of colonisation on women's health by evaluating the influence of foreign aid policies, structural programmes, and shifting gender norms. Applying a syndemic approach, juxtaposed by historical contextualisation, offers important implications for the prevention and treatment of HIV/AIDS, STIs, and NTDs. Our analysis suggests a perspective through which to view health of regions with a history of colonisation.
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Affiliation(s)
- Mehar Maju
- a Department of Community Health Sciences, UCLA Fielding School of Public Health , Los Angeles, CA , USA.,b Department of Anthropology , Boston University , Boston, MA , USA
| | - Andria Sharma
- c Department of Biology , Boston University , Boston, MA , USA.,d Rutgers New Jersey Medical School, School of Medicine, Newark , New Jersey , USA
| | - Archana Beeram
- c Department of Biology , Boston University , Boston, MA , USA.,e Imperial College London, School of Public Health , London , UK
| | - Bayla Ostrach
- f Family Medicine, and Affiliated Faculty, Medical Anthropology , Boston University School of Medicine , Boston, MA.,g Sociology and Anthropology , University of North Carolina Asheville , NC , USA
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Yegorov S, Galiwango RM, Good SV, Mpendo J, Tannich E, Boggild AK, Kiwanuka N, Bagaya BS, Kaul R. Schistosoma mansoni infection and socio-behavioural predictors of HIV risk: a cross-sectional study in women from Uganda. BMC Infect Dis 2018; 18:586. [PMID: 30453907 PMCID: PMC6245923 DOI: 10.1186/s12879-018-3481-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 10/31/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schistosoma mansoni infection has been associated with increased risk of HIV transmission in African women. This association might be causal or mediated through shared socio-behavioural factors and associated co-infections. We tested the latter hypothesis in a cross-sectional pilot study in a cohort of women from a S. mansoni endemic region of Uganda. To validate the immunological effects of S. mansoni in this cohort, we additionally assessed known schistosomiasis biomarkers. METHODS HIV-uninfected non-pregnant adult women using public health services were tested for schistosomiasis using the urine circulating cathodic antigen test, followed by serology and Schistosoma spp.-specific PCR. Blood was obtained for herpes simplex virus (HSV)-2 serology, eosinophil counts and cytokine analysis. Samples collected from the genitourinary tract were used to test for classical sexually transmitted infections (STI), for bacterial vaginosis and to assess recent sexual activity via prostate-specific antigen testing. Questionnaires were used to capture a range of socio-economic and behavioral characteristics. RESULTS Among 58 participants, 33 (57%) had schistosomiasis, which was associated with elevated levels of interleukin (IL)-10 (0.32 vs. 0.19 pg/ml; p = 0.038) and a trend toward increased tumour necrosis factor (TNF) (1.73 vs. 1.42 pg/ml; p = 0.081). Eosinophil counts correlated with levels of both cytokines (r = 0.53, p = 0.001 and r = 0.38, p = 0.019, for IL-10 and TNF, respectively); the association of eosinophilia with schistosomiasis was not significant (OR = 2.538, p = 0.282). Further, schistosomiasis was associated with lower age (per-year OR = 0.910, p = 0.047), being unmarried (OR = 0.263, p = 0.030), less frequent hormonal contraceptive (HC) use (OR = 0.121, p = 0.002, dominated by long acting injectable contraceptives) and a trend to longer time since penile-vaginal sex (OR = 0.350, p = 0.064). All women infected by Chlamydia trachomatis (n = 5), were also positive for schistosomiasis (Fisher's exact p = 0.064). CONCLUSIONS Intestinal schistosomiasis in adult women was associated with systemic immune alterations, suggesting that associations with immunological correlates of HIV susceptibility warrant further investigation. S. mansoni associations with socio-behavioral parameters and C. trachomatis, which may alter both genital immunity and HIV exposure and/or acquisition risk, means that future studies should carefully control for potential confounders. These findings have implications for the design and interpretation of clinical studies on the effects of schistosomiasis on HIV acquisition.
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Affiliation(s)
- Sergey Yegorov
- Department of Immunology, University of Toronto, Toronto, Canada. .,Present address: Faculty of Education and Humanities, Suleyman Demirel University, Almaty, Kazakhstan.
| | | | - Sara V Good
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Juliet Mpendo
- Uganda Virus Research Institute -International AIDS Vaccine Initiative HIV Vaccine Program, Entebbe, Uganda
| | - Egbert Tannich
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Andrea K Boggild
- Department of Medicine, University of Toronto, Toronto, Canada.,Public Health Ontario Laboratories, Toronto, Canada
| | - Noah Kiwanuka
- Uganda Virus Research Institute -International AIDS Vaccine Initiative HIV Vaccine Program, Entebbe, Uganda.,Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Bernard S Bagaya
- Uganda Virus Research Institute -International AIDS Vaccine Initiative HIV Vaccine Program, Entebbe, Uganda.,Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rupert Kaul
- Department of Immunology, University of Toronto, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
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Coinfections between Persistent Parasitic Neglected Tropical Diseases and Viral Infections among Prisoners from Sub-Saharan Africa and Latin America. J Trop Med 2018; 2018:7218534. [PMID: 30532789 PMCID: PMC6247427 DOI: 10.1155/2018/7218534] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/23/2018] [Accepted: 10/03/2018] [Indexed: 12/12/2022] Open
Abstract
In Swiss prisons, more than 70% of detained people are foreigners and over one-third originate from sub-Saharan Africa or Latin America. These two regions are endemic for various tropical diseases and viral infections, which persist after migration to nonendemic countries. Parasitic infections (schistosomiasis; strongyloidiasis) and cooccurrent viral infections (HIV, hepatitis B (HBV), and hepatitis C (HCV)) are especially of concern for clinical care but have been neglected in empirical research. These diseases often remain silent for years before causing complications, especially if they occur concomitantly. Our research aimed to study the prevalence rates and coinfections of two neglected tropical diseases, namely, Strongyloides stercoralis and Schistosoma sp. and viral infections among sub-Saharan Africans (SSA) and Latin Americans (LA) in Switzerland's largest pretrial prison. We carried out a cross-sectional prevalence study using a standardized questionnaire and serological testing. Among the 201 participants, 85.6% were SSA and 14.4% LA. We found the following prevalence ratios: 3.5% of HIV (4.1% in SSA, 0% in LA), 12.4% of chronic HBV (14.5% in SSA, 0% in LA), 2.0% of viraemic HCV (1.7% in SSA, 3.4% in LA), and 8.0% of strongyloidiasis (8.1% in SSA, 6.9% in LA). The serological prevalence of schistosomiasis among SSA was 20.3% (not endemic in Latin America). Two infections were simultaneously detected in SSA: 4.7% were coinfected with schistosomiasis and chronic HBV. Four other coinfections were detected among SSA: schistosomiasis-HIV, HIV-chronic HBV, HIV-HCV, and schistosomiasis-strongyloidiasis. To conclude, the high prevalence rates of persistent viral and parasitic infections and their potential coinfections among SSA and LA detained migrants highlight the need to implement control strategies and programs that reach people in detention centers in nonendemic countries.
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Effect of schistosomiasis on the outcome of patients infected with HIV-1 starting antiretroviral therapy in rural Tanzania. PLoS Negl Trop Dis 2018; 12:e0006844. [PMID: 30332404 PMCID: PMC6205655 DOI: 10.1371/journal.pntd.0006844] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 10/29/2018] [Accepted: 09/13/2018] [Indexed: 01/04/2023] Open
Abstract
Background It has been hypothesized that schistosomiasis negatively influences immune reconstitution in people living with HIV starting antiretroviral therapy (ART). In this study, we investigated the effect of schistosomiasis on the course of HIV infection in patients starting ART in a rural part of Tanzania. Methodology Retrospective study including patients prospectively enrolled in a HIV cohort in Ifakara, south-central Tanzania between January 1, 2013 and April 1, 2015. Schistosomal circulating anodic antigen (CAA) was assessed in pre-ART cryopreserved plasma. Regression models were utilized to estimate the effect of CAA positivity on virological and immunological failure and a composite outcome of death/loss to follow-up (LFU). Principal findings At ART-initiation 19.1% (88/461) of patients were CAA-positive. A tendency of higher CD4 increases was seen in CAA-positive patients (+182 cells/μl, interquartile range (IQR), 87–285 cells/μl) compared to CAA-negative patients (+147 cells/μl, IQR, 55–234 cells/μl, p = 0.09) after 10 months of follow-up. After adjustment for baseline risk factors, CAA-positivity showed no association with virological or immunological failure. In CAA-positive patients, 22.7% (20/88) died or were LFU, compared to 29.5% (110/373) of CAA-negative patients (hazard ratio (HR): 0.76, 95% confidence interval (CI), 0.47–1.22, p = 0.25). After adjustment for age, sex, body mass index, educational attainment, WHO-stage, tuberculosis status, and year of ART initiation, CAA-positivity showed a trend of a decreased hazard of death/LFU (HR: 0.58, 95% CI: 0.32–1.05, p = 0.07), while CD4 count at baseline (HR: 0.86, 95% CI: 0.76–1.00, p = 0.02) and MXD (sum of eosinophils, basophils, and monocytes counts) >1,100 cells/μl (HR: 0.56, 95% CI: 0.34–0.93, p = 0.03) were identified as independently protective factors. Conclusions/Significance Schistosomiasis is prevalent in this HIV cohort and may be beneficial for immunological reconstitution, while no effect on virological failure was apparent. A positive effect of schistosomiasis-induced immunomodulation on survival and retention in care needs confirmation in future studies. Infections with HIV and blood flukes (Schistosoma) both exert chronic modulatory effects on the host’s immune system. Coinfections, meaning the host is simultaneously infected with both pathogens, are common in sub-Saharan Africa. In this situation the induced immune modulation of one pathogen may affect the course of the disease induced by the other pathogen. One study showed that coinfection with Schistosoma in people living with HIV who begin antiretroviral therapy (ART) may have deleterious effects on the reconstitution of the HIV-induced immunosuppression. In the current study, we investigated the effect of Schistosoma coinfection on the recovery of the patient’s immune system, on the efficacy of ART to suppress HIV replication, and on a combined endpoint of lost to follow-up or death. We found that schistosomiasis may have beneficial effects on immune reconstitution, while no deleterious effect was detected on HIV-suppressive efficacy of ART. Surprisingly, our data suggest that schistosomiasis-induced immunomodulatory effects might be beneficial for survival and retention in care. Future studies are warranted to confirm these findings. In the era of increasing access to ART in sub-Saharan Africa, the issue of schistosomiasis-HIV coinfection may have major consequences on the outcome of HIV treatment programs.
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Walwyn-Brown K, Guldevall K, Saeed M, Pende D, Önfelt B, MacDonald AS, Davis DM. Human NK Cells Lyse Th2-Polarizing Dendritic Cells via NKp30 and DNAM-1. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2018; 201:2028-2041. [PMID: 30120122 PMCID: PMC6139540 DOI: 10.4049/jimmunol.1800475] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/23/2018] [Indexed: 01/08/2023]
Abstract
Cross-talk between NK cells and dendritic cells (DCs) is important in Th1 immune responses, including antitumor immunity and responses to infections. DCs also play a crucial role in polarizing Th2 immunity, but the impact of NK cell-DC interactions in this context remains unknown. In this study, we stimulated human monocyte-derived DCs in vitro with different pathogen-associated molecules: LPS or polyinosinic-polycytidylic acid, which polarize a Th1 response, or soluble egg Ag from the helminth worm Schistosoma mansoni, a potent Th2-inducing Ag. Th2-polarizing DCs were functionally distinguishable from Th1-polarizing DCs, and both showed distinct morphology and dynamics from immature DCs. We then assessed the outcome of autologous NK cells interacting with these differently stimulated DCs. Confocal microscopy showed polarization of the NK cell microtubule organizing center and accumulation of LFA-1 at contacts between NK cells and immature or Th2-polarizing DCs but not Th1-polarizing DCs, indicative of the assembly of an activating immune synapse. Autologous NK cells lysed immature DCs but not DCs treated with LPS or polyinosinic-polycytidylic acid as reported previously. In this study, we demonstrated that NK cells also degranulated in the presence of Th2-polarizing DCs. Moreover, time-lapse live-cell microscopy showed that DCs that had internalized fluorescently labeled soluble egg Ag were efficiently lysed. Ab blockade of NK cell-activating receptors NKp30 or DNAM-1 abrogated NK cell lysis of Th2-polarizing DCs. Thus, these data indicate a previously unrecognized role of NK cell cytotoxicity and NK cell-activating receptors NKp30 and DNAM-1 in restricting the pool of DCs involved in Th2 immune responses.
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Affiliation(s)
- Katherine Walwyn-Brown
- Manchester Collaborative Centre for Inflammation Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9NT, United Kingdom
| | - Karolin Guldevall
- Department of Applied Physics, Science for Life Laboratory, KTH Royal Institute of Technology, Solna, SE-106 91 Stockholm, Sweden
| | - Mezida Saeed
- Manchester Collaborative Centre for Inflammation Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9NT, United Kingdom
| | - Daniela Pende
- Laboratorio Immunologia, Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Policlinico San Martino, 16132 Genova, Italy; and
| | - Björn Önfelt
- Department of Applied Physics, Science for Life Laboratory, KTH Royal Institute of Technology, Solna, SE-106 91 Stockholm, Sweden
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Andrew S MacDonald
- Manchester Collaborative Centre for Inflammation Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9NT, United Kingdom
| | - Daniel M Davis
- Manchester Collaborative Centre for Inflammation Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9NT, United Kingdom;
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Abstract
Schistosomiasis (bilharzia) is a neglected tropical disease caused by parasitic flatworms (blood flukes) of the genus Schistosoma, with considerable morbidity in parts of the Middle East, South America, Southeast Asia and, particularly, in sub-Saharan Africa. Infective larvae grow in an intermediate host (fresh-water snails) before penetrating the skin of the definitive human host. Mature adult worms reside in the mesenteric (Schistosoma mansoni and Schistosoma japonicum) or pelvic (Schistosoma haematobium) veins, where female worms lay eggs, which are secreted in stool or urine. Eggs trapped in the surrounding tissues and organs, such as the liver and bladder, cause inflammatory immune responses (including granulomas) that result in intestinal, hepato-splenic or urogenital disease. Diagnosis requires the detection of eggs in excreta or worm antigens in the serum, and sensitive, rapid, point-of-care tests for populations living in endemic areas are needed. The anti-schistosomal drug praziquantel is safe and efficacious against adult worms of all the six Schistosoma spp. infecting humans; however, it does not prevent reinfection and the emergence of drug resistance is a concern. Schistosomiasis elimination will require a multifaceted approach, including: treatment; snail control; information, education and communication; improved water, sanitation and hygiene; accurate diagnostics; and surveillance-response systems that are readily tailored to social-ecological settings.
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Affiliation(s)
- Donald P McManus
- Immunology Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia.
| | - David W Dunne
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Moussa Sacko
- Department of Diagnostic and Biomedical Research, Institut National de Recherche en Santé Publique, Bamako, Mali
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Birgitte J Vennervald
- Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Shanghai, People's Republic of China
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Colombe S, Machemba R, Mtenga B, Lutonja P, Kalluvya SE, de Dood CJ, Hoekstra PT, van Dam GJ, Corstjens PLAM, Urassa M, Changalucha JM, Todd J, Downs JA. Impact of schistosome infection on long-term HIV/AIDS outcomes. PLoS Negl Trop Dis 2018; 12:e0006613. [PMID: 29965987 PMCID: PMC6044552 DOI: 10.1371/journal.pntd.0006613] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/13/2018] [Accepted: 06/15/2018] [Indexed: 01/31/2023] Open
Abstract
Background Africa bears the burden of approximately 70% of global HIV infections and 90% of global schistosome infections. We sought to investigate the impact of schistosome infection at the time of HIV-1 seroconversion on the speed of HIV-1 disease progression, as measured by the outcome CD4+ T-cell (CD4) counts <350 cells/μL and/or death. We hypothesized that people who had been infected with Schistosoma spp. at the time they acquired HIV-1 infection would have impaired antiviral immune response, thus leading them to progress twice as fast to a CD4 count less than 350 cells/μL or death than would people who had been free of schistosomes at time of HIV-1 seroconversion. Methods and principal findings We conducted a longitudinal study in Tanzania from 2006 to 2017 using stored blood spot samples, demographic surveillance and sero-survey data from the community, and a review of clinical charts. A competing risk analysis was performed to look at the difference in time to reaching CD4 counts < 350 cells/μL and/or death in HIV-1-infected people who were infected versus not infected with Schistosoma spp. at time of HIV-1 seroconversion. We found an 82% reduction in risk of reaching the outcome in seroconverters who had been infected with Schistosoma (subHazard Ratio = 0.18[0.068,0.50], p = 0.001) after adjusting for age, occupation, clinic attendance and time-dependent covariates. Conclusions Our study demonstrates that people with schistosome infection at the time of HIV-seroconversion develop adverse HIV outcomes more slowly than those without. The findings are contrary to our original hypothesis. Our current longitudinal findings suggest complex interactions between HIV-1 and schistosome co-infections that may be modulated over time. We urge new immunological studies to investigate the long-term impact of schistosome infection on HIV-1 viral load and CD4 counts as well as related immunologic pathways. Several studies had shown that people infected with schistosome parasites were at risk of getting HIV and that they may have higher HIV viral concentrations in their blood as well. The authors explored the impact of the parasite on HIV disease after infection, expecting that people co-infected with the parasite at time of HIV-infection would develop worse HIV outcomes than people who did not have the parasite. HIV seroconverters were identified among a large cohort tested regularly for HIV in northwest Tanzania and were followed-up in clinics to determine their CD4 + T-cells counts and mortality. The seroconverters’ stored blood samples were tested for infection with the parasite and outcomes were compared between seroconverters who were and were not infected with the parasites at the time that they became HIV-infected. The authors surprisingly found that people with the parasite experienced fewer negative outcomes of HIV than people who did not have the parasite. To the investigators’ knowledge, this is the first longitudinal study to find this result. Long-term immunological changes may explain this protective effect and more studies are recommended to explore this research question.
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Affiliation(s)
- Soledad Colombe
- Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
- * E-mail:
| | | | | | - Peter Lutonja
- National Institute of Medical Research, Mwanza, Tanzania
| | | | - Claudia J. de Dood
- Department of Molecular Cell Biology, Leiden University Medical Centre, Leiden, Netherlands
| | - Pytsje T. Hoekstra
- Department of Parasitology, Leiden University Medical Centre, Leiden, Netherlands
| | - Govert J. van Dam
- Department of Parasitology, Leiden University Medical Centre, Leiden, Netherlands
| | | | - Mark Urassa
- National Institute of Medical Research, Mwanza, Tanzania
| | | | - Jim Todd
- Department of Applied Biostatistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jennifer A. Downs
- Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Bugando Medical Centre, Mwanza, Tanzania
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Kinases: Molecular Stage Directors for Schistosome Development and Differentiation. Trends Parasitol 2017; 34:246-260. [PMID: 29276074 DOI: 10.1016/j.pt.2017.12.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 01/03/2023]
Abstract
Understanding schistosome biology is still a challenging mission. The reproductive biology of this parasitic trematode is closely associated with the pathologic consequences of schistosomiasis, the devastating infectious disease caused by members of the family Schistosomatidae worldwide. Recent studies of signaling mechanisms confirmed the prominent roles of protein kinases (PKs) in directing schistosome biology, and first evidence was obtained for an additional contribution of kinases with substrates different from proteins (non-PKs). This review provides an overview of the Schistosoma mansoni kinome in the context of male-female interaction and summarizes recent studies of kinases controlling development and differentiation. Due to their importance for schistosome biology, kinases represent Achilles' heels and are therefore of high value also for translational research.
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Abstract
Praziquantel has remained the drug of choice for schistosomiasis chemotherapy for almost 40 years. The pressing need to develop a new antischistosomal drug may necessitate exploring and filtering chemotherapeutic history to search for the most promising ones. In this context, this review attempts to summarize all progress made in schistosomiasis chemotherapy from the early 20th century (mid-1910s) to 2016. We gathered almost 100 compounds providing information on therapeutic action, specifically covering at least first in vivo studies in animal model and in vitro. Pharmacokinetic and toxicity profiles of antischistosomal agents were also described. Preclinical studies indicate a handful of promising future candidates.
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32
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Evans EE, Siedner MJ. Tropical Parasitic Infections in Individuals Infected with HIV. CURRENT TROPICAL MEDICINE REPORTS 2017; 4:268-280. [PMID: 33842194 PMCID: PMC8034600 DOI: 10.1007/s40475-017-0130-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW Neglected tropical diseases share both geographic and socio-behavioral epidemiological risk factors with HIV infection. In this literature review, we describe interactions between parasitic diseases and HIV infection, with a focus on the impact of parasitic infections on HIV infection risk and disease progression, and the impact of HIV infection on clinical characteristics of tropical parasitic infections. We limit our review to tropical parasitic infections of the greatest public health burden, and exclude discussion of classic HIV-associated opportunistic infections that have been well reviewed elsewhere. RECENT FINDINGS Tropical parasitic infections, HIV-infection, and treatment with antiretroviral therapy alter host immunity, which can impact susceptibility, transmissibility, diagnosis, and severity of both HIV and parasitic infections. These relationships have a broad range of consequences, from putatively increasing susceptibility to HIV acquisition, as in the case of schistosomiasis, to decreasing risk of protozoal infections through pharmacokinetic interactions between antiretroviral therapy and antiparasitic agents, as in the case of malaria. However, despite this intimate interplay in pathophysiology and a broad overlap in epidemiology, there is a general paucity of data on the interactions between HIV and tropical parasitic infections, particularly in the era of widespread antiretroviral therapy availability. SUMMARY Additional data are needed to motivate clinical recommendations for detection and management of parasitic infections in HIV-infected individuals, and to consider the implications of and potential opportunity granted by HIV treatment programs on parasitic disease control.
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Affiliation(s)
| | - Mark J Siedner
- Massachusetts General Hospital
- Harvard Medical School
- Mbarara University of Science and Technology
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33
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Urogenital Schistosomiasis—Evidence-Based Benefits of Treatment Initiated Early During Childhood. CURRENT CLINICAL MICROBIOLOGY REPORTS 2017. [DOI: 10.1007/s40588-017-0077-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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34
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Downs JA, Dupnik KM, van Dam GJ, Urassa M, Lutonja P, Kornelis D, de Dood CJ, Hoekstra P, Kanjala C, Isingo R, Peck RN, Lee MH, Corstjens PLAM, Todd J, Changalucha JM, Johnson WD, Fitzgerald DW. Effects of schistosomiasis on susceptibility to HIV-1 infection and HIV-1 viral load at HIV-1 seroconversion: A nested case-control study. PLoS Negl Trop Dis 2017; 11:e0005968. [PMID: 28945756 PMCID: PMC5629028 DOI: 10.1371/journal.pntd.0005968] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/05/2017] [Accepted: 09/17/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Schistosomiasis affects 218 million people worldwide, with most infections in Africa. Prevalence studies suggest that people with chronic schistosomiasis may have higher risk of HIV-1 acquisition and impaired ability to control HIV-1 replication once infected. We hypothesized that: (1) pre-existing schistosome infection may increase the odds of HIV-1 acquisition and that the effects may differ between men and women, and (2) individuals with active schistosome infection at the time of HIV-1 acquisition may have impaired immune control of HIV-1, resulting in higher HIV-1 viral loads at HIV-1 seroconversion. METHODOLOGY/PRINCIPAL FINDINGS We conducted a nested case-control study within a large population-based survey of HIV-1 transmission in Tanzania. A population of adults from seven villages was tested for HIV in 2007, 2010, and 2013 and dried blood spots were archived for future studies with participants' consent. Approximately 40% of this population has Schistosoma mansoni infection, and 2% has S. haematobium. We tested for schistosome antigens in the pre- and post-HIV-1-seroconversion blood spots of people who acquired HIV-1. We also tested blood spots of matched controls who did not acquire HIV-1 and calculated the odds that a person with schistosomiasis would become HIV-1-infected compared to these matched controls. Analysis was stratified by gender. We compared 73 HIV-1 seroconverters with 265 controls. Women with schistosome infections had a higher odds of HIV-1 acquisition than those without (adjusted OR = 2.8 [1.2-6.6], p = 0.019). Schistosome-infected men did not have an increased odds of HIV-1 acquisition (adjusted OR = 0.7 [0.3-1.8], p = 0.42). We additionally compared HIV-1 RNA levels in the post-seroconversion blood spots in HIV-1 seroconverters with schistosomiasis versus those without who became HIV-infected in 2010, before antiretroviral therapy was widely available in the region. The median whole blood HIV-1 RNA level in the 15 HIV-1 seroconverters with schistosome infection was significantly higher than in the 22 without schistosomiasis: 4.4 [3.9-4.6] log10 copies/mL versus 3.7 [3.2-4.3], p = 0.017. CONCLUSIONS/SIGNIFICANCE We confirm, in an area with endemic S. mansoni, that pre-existing schistosome infection increases odds of HIV-1 acquisition in women and raises HIV-1 viral load at the time of HIV-1 seroconversion. This is the first study to demonstrate the effect of schistosome infection on HIV-1 susceptibility and viral control, and to differentiate effects by gender. Validation studies will be needed at additional sites.
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Affiliation(s)
- Jennifer A. Downs
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Bugando Medical Centre, Mwanza, Tanzania
- * E-mail:
| | - Kathryn M. Dupnik
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Govert J. van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Mark Urassa
- National Institute for Medical Research, Mwanza, Tanzania
| | - Peter Lutonja
- National Institute for Medical Research, Mwanza, Tanzania
| | - Dieuwke Kornelis
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Claudia J. de Dood
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pytsje Hoekstra
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Raphael Isingo
- National Institute for Medical Research, Mwanza, Tanzania
| | - Robert N. Peck
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Bugando Medical Centre, Mwanza, Tanzania
| | - Myung Hee Lee
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Paul L. A. M. Corstjens
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jim Todd
- Department of Applied Biostatistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Warren D. Johnson
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Daniel W. Fitzgerald
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
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Midzi N, Mduluza T, Mudenge B, Foldager L, Leutscher PDC. Decrease in Seminal HIV-1 RNA Load After Praziquantel Treatment of Urogenital Schistosomiasis Coinfection in HIV-Positive Men-An Observational Study. Open Forum Infect Dis 2017; 4:ofx199. [PMID: 29181419 PMCID: PMC5695621 DOI: 10.1093/ofid/ofx199] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 09/12/2017] [Indexed: 12/14/2022] Open
Abstract
Background Urogenital schistosomiasis due to Schistosoma hematobium infection is hypothesized to cause increased HIV-1 RNA shedding in semen in HIV co-infected men as result of chronic egg-induced inflammation in the prostate and the seminal vesicles. The effect of treatment with the antihelminthic agent praziquantel on seminal HIV-1 RNA load was assessed in this study. Methods HIV-1 RNA load was determined in blood plasma and semen at baseline and at 10-week follow-up. Praziquantel was administered at baseline and two weeks later. Results Eighteen HIV-positive men with S. haematobium co-infection were enrolled into the study. Status of antiretroviral therapy (ART): 6 ART-naïve and 12 ART-experienced. All participants became egg-negative in urine at follow-up. Among the ART-naïve men, the mean HIV-1 RNA load decreased by 0.32 log10 copies per mL (4.41 vs 4.09) in blood plasma from baseline to follow-up, and in semen by 1.06 log10 copies per mL (4.06 vs 3.00). Conclusions This study demonstrated a decline in seminal HIV-1 RNA load following praziquantel treatment of urogenital schistosomiasis infection in HIV-positive men. The finding needs further exploration in a larger randomized study targeting praziquantel as a supplementary preventive measure of sexual transmission of HIV-1 in S. haematobium endemic areas in sub-Saharan Africa.
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Affiliation(s)
- Nicholas Midzi
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Avondale, Harare, Zimbabwe
| | - Takafira Mduluza
- Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe.,School of Laboratory Medicine and Medical Sciences, University of KwaZulu Natal, Durban, South Africa
| | | | - Leslie Foldager
- Department of Animal Science, Aarhus University, Aarhus, Denmark.,Bioinformatics Research Centre, Aarhus University, Tjele, Denmark
| | - Peter D C Leutscher
- Centre of Clinical Research, Regional Hospital North Denmark, Denmark.,Clinical Institute, Aalborg University, Denmark
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Rodrigues JPF, Caldas IS, Gonçalves RV, Almeida LA, Souza RLM, Novaes RD. S. mansoni-T. cruzi co-infection modulates arginase-1/iNOS expression, liver and heart disease in mice. Nitric Oxide 2017; 66:43-52. [PMID: 28268114 DOI: 10.1016/j.niox.2017.02.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 02/17/2017] [Accepted: 02/27/2017] [Indexed: 12/30/2022]
Abstract
Although Schistosoma species and Trypanosoma cruzi share common endemic areas, co-infections by these parasites remains overlooked. By using a murine model of S. mansoni and T. cruzi co-infection, we investigated if and to what extent these infections might interact to change the pathological outcomes typically observed when the host is infected by a single parasite species. Swiss mice were randomized into four groups: uninfected (NI) and those infected by S. mansoni (SM), T. cruzi (TC) or co-infected (SM + TC). After 120 days of S. mansoni infection, T. cruzi was concurrently inoculated and the infection occurred for 30 days. Taken together, we identified that the overlap of Th2 (schistosomiasis) and Th1 (Chagas disease) immunological patterns changes the host resistance against both pathogens. Beyond impairing the control of granulomatous inflammation, T. cruzi parasitemia and parasitism in co-infected animals, the Th2 inflammatory response against S. mansoni elicits the activation of the arginase-1 pathway to the detriment of inducible oxide nitric synthase (iNOS) expression and nitric oxide (NO) production, contributing to the liver damage, with minor effects on heart pathology.
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Affiliation(s)
| | - Ivo Santana Caldas
- Department of Pathology and Parasitology, Federal University of Alfenas, Alfenas, Minas Gerais, 37130-000, Brazil
| | | | - Leonardo Augusto Almeida
- Department of Microbiology and Immunology, Federal University of Alfenas, Alfenas, Minas Gerais, 37130-000, Brazil
| | - Raquel Lopes Martins Souza
- Department of Pathology and Parasitology, Federal University of Alfenas, Alfenas, Minas Gerais, 37130-000, Brazil
| | - Rômulo Dias Novaes
- Department of Structural Biology, Federal University of Alfenas, Alfenas, Minas Gerais, 37130-000, Brazil.
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Montague BT, Salas CM, Montague TL, Mileno MD. The immunosuppressed patient. Infect Dis (Lond) 2017. [DOI: 10.1002/9781119085751.ch28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Brian T. Montague
- Division of Infectious Diseases; University of Colorado; Aurora Colorado USA
| | | | | | - Maria D. Mileno
- Warren Alpert Medical School; Brown University; Providence Rhode Island USA
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Editorial Office of Asian Biomedicine. Editorial. Control of neglected tropical diseases: the need to integrate knowledge, social, and political processes. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0806.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Blohm AS, Mäder P, Quack T, Lu Z, Hahnel S, Schlitzer M, Grevelding CG. Derivatives of biarylalkyl carboxylic acid induce pleiotropic phenotypes in adult Schistosoma mansoni in vitro. Parasitol Res 2016; 115:3831-42. [PMID: 27230017 DOI: 10.1007/s00436-016-5146-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 05/19/2016] [Indexed: 12/17/2022]
Abstract
Schistosomes and other parasitic platyhelminths cause infectious diseases of worldwide significance for humans and animals. Despite their medical and economic importance, vaccines are not available and the number of drugs is alarmingly limited. For most platyhelminths including schistosomes, Praziquantel (PZQ) is the commonly used drug. With respect to its regular application in mass treatment programs, however, there is increasing concern about resistance development.Previous studies demonstrated that inhibitors used to treat non-parasitic human diseases may be useful to be tested for their effects on parasites. To this end, we focused on biarylalkyl carboxylic acids (BACAs) as basis, which had been shown before to be interesting candidates in the context of finding alternative approaches to treat diabetes mellitus. We tested 32 chemically modified derivatives of these substances (biarylalkyl carboxylic acid derivatives (BACADs)) for their effects on adult Schistosoma mansoni in vitro. Treatment with 18 BACADs resulted in egg production-associated phenotypes and reduced pairing stability. In addition, 12 of these derivatives affected vitality and/or caused severe tegument damage, gut dilatation, or other forms of tissue disintegration which led to the death of worms. In most cases (10/12), one derivative caused more than one phenotype at a time. In vitro experiments in the presence of serum albumin (SA) and alpha-acidic glycoprotein (AGP) indicated a varying influence of these blood components on the effects of two selected derivatives. The variety of observed phenotypes suggested that different targets were hit. The results demonstrated that BACADs are interesting substances with respect to their anti-schistosomal effects.
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Affiliation(s)
- Ariane S Blohm
- BFS, Institut for Parasitology, Justus-Liebig-University Gießen, Gießen, 35392, Germany
| | - Patrick Mäder
- Institute for Pharmaceutic Chemistry, Philipps-University Marburg, Marburg, 35032, Germany
| | - Thomas Quack
- BFS, Institut for Parasitology, Justus-Liebig-University Gießen, Gießen, 35392, Germany
| | - Zhigang Lu
- BFS, Institut for Parasitology, Justus-Liebig-University Gießen, Gießen, 35392, Germany
| | - Steffen Hahnel
- BFS, Institut for Parasitology, Justus-Liebig-University Gießen, Gießen, 35392, Germany
| | - Martin Schlitzer
- Institute for Pharmaceutic Chemistry, Philipps-University Marburg, Marburg, 35032, Germany
| | - Christoph G Grevelding
- BFS, Institut for Parasitology, Justus-Liebig-University Gießen, Gießen, 35392, Germany.
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Simon GG. Impacts of neglected tropical disease on incidence and progression of HIV/AIDS, tuberculosis, and malaria: scientific links. Int J Infect Dis 2015; 42:54-57. [PMID: 26594012 DOI: 10.1016/j.ijid.2015.11.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/19/2015] [Accepted: 11/07/2015] [Indexed: 01/15/2023] Open
Abstract
The neglected tropical diseases (NTDs) are the most common infections of humans in Sub-Saharan Africa. Virtually all of the population living below the World Bank poverty figure is affected by one or more NTDs. New evidence indicates a high degree of geographic overlap between the highest-prevalence NTDs (soil-transmitted helminths, schistosomiasis, onchocerciasis, lymphatic filariasis, and trachoma) and malaria and HIV, exhibiting a high degree of co-infection. Recent research suggests that NTDs can affect HIV and AIDS, tuberculosis (TB), and malaria disease progression. A combination of immunological, epidemiological, and clinical factors can contribute to these interactions and add to a worsening prognosis for people affected by HIV/AIDS, TB, and malaria. Together these results point to the impacts of the highest-prevalence NTDs on the health outcomes of malaria, HIV/AIDS, and TB and present new opportunities to design innovative public health interventions and strategies for these 'big three' diseases. This analysis describes the current findings of research and what research is still needed to strengthen the knowledge base of the impacts NTDs have on the big three.
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Affiliation(s)
- G G Simon
- Management Sciences for Health, Arlington VA, USA.
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41
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Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, de Souza Dias BF, Ezeh A, Frumkin H, Gong P, Head P, Horton R, Mace GM, Marten R, Myers SS, Nishtar S, Osofsky SA, Pattanayak SK, Pongsiri MJ, Romanelli C, Soucat A, Vega J, Yach D. Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation-Lancet Commission on planetary health. Lancet 2015; 386:1973-2028. [PMID: 26188744 DOI: 10.1016/s0140-6736(15)60901-1] [Citation(s) in RCA: 977] [Impact Index Per Article: 108.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Sarah Whitmee
- Centre for Biodiversity and Environment Research, University College London, London, UK.
| | - Andy Haines
- London School of Hygiene & Tropical Medicine, London, UK
| | - Chris Beyrer
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Anthony G Capon
- International Institute for Global Health, United Nations University, Federal Territory of Kuala Lumpur, Malaysia
| | | | - Alex Ezeh
- African Population and Health Research Center, Nairobi, Kenya
| | - Howard Frumkin
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Peng Gong
- Center for Earth System Science, Tsinghua University, Beijing, China
| | - Peter Head
- The Ecological Sequestration Trust, London, UK
| | | | - Georgina M Mace
- Centre for Biodiversity and Environment Research, University College London, London, UK
| | - Robert Marten
- London School of Hygiene & Tropical Medicine, London, UK; The Rockefeller Foundation, New York, NY, USA
| | - Samuel S Myers
- Center for the Environment, Harvard University, Cambridge, MA, USA; Harvard T.H. Chan School of Public Health, Islamabad, Pakistan
| | | | | | - Subhrendu K Pattanayak
- Sanford School of Public Policy and Nicholas School of the Environment, Duke University, Durham, NC, USA
| | | | | | | | - Jeanette Vega
- The National Chilean Public Health Insurance Agency, Santiago, Chile
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Stecher CW, Kallestrup P, Kjetland EF, Vennervald B, Petersen E. Considering treatment of male genital schistosomiasis as a tool for future HIV prevention: a systematic review. Int J Public Health 2015; 60:839-48. [PMID: 26298443 DOI: 10.1007/s00038-015-0714-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 06/26/2015] [Accepted: 07/03/2015] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES Male genital schistosomiasis (MGS) is a neglected manifestation of Schistosoma haematobium infection with ignored implications on reproductive health and a differential diagnosis to sexually transmitted infections in endemic regions. MGS may have associations with HIV transmission and acquisition, and treatment could be a neglected chance of HIV prevention. This review summarizes current knowledge on epidemiology, clinical manifestations, diagnosis and treatment of MGS as a hypothesized risk factor for HIV transmission. Future research areas of global interest are suggested. METHODS PubMed published literature was reviewed based on the MOOSE guidelines. All publications on MGS were included regardless of publication year and study design. Furthermore, all publications were searched for information on possible HIV association. RESULTS The 40 identified publications related to MGS were dominated by case reports and observational studies. No randomized clinical trials have been conducted to date, and very scant information related to possible associations with HIV transmission was presented. CONCLUSIONS Clinical, randomized studies and epidemiological studies covering the possible association between MGS and HIV are urgently needed. Furthermore, field diagnostic tools should be developed and future mass treatment programs should include adults to reduce morbidity and prevent HIV acquisition. SYSTEMATIC REVIEW REGISTRATION NUMBER CRD42015016252.
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Affiliation(s)
- Chalotte Willemann Stecher
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
- Center for Global Health (GloHAU), Aarhus University, Aarhus, Denmark.
| | - Per Kallestrup
- Center for Global Health (GloHAU), Aarhus University, Aarhus, Denmark.
| | - Eyrun Floerecke Kjetland
- Norwegian Centre for Imported and Tropical Diseases, Oslo University Hospital, Oslo, Norway.
- Discipline of Public Health Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
| | - Birgitte Vennervald
- Department of Parasitology and Aquatic Diseases, University of Copenhagen, Copenhagen, Denmark.
| | - Eskild Petersen
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
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Vaumourin E, Vourc'h G, Gasqui P, Vayssier-Taussat M. The importance of multiparasitism: examining the consequences of co-infections for human and animal health. Parasit Vectors 2015; 8:545. [PMID: 26482351 PMCID: PMC4617890 DOI: 10.1186/s13071-015-1167-9] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 10/14/2015] [Indexed: 11/23/2022] Open
Abstract
Most parasites co-occur with other parasites, although the importance of such multiparasitism has only recently been recognised. Co-infections may result when hosts are independently infected by different parasites at the same time or when interactions among parasite species facilitate co-occurrence. Such interactions can have important repercussions on human or animal health because they can alter host susceptibility, infection duration, transmission risks, and clinical symptoms. These interactions may be synergistic or antagonistic and thus produce diverse effects in infected humans and animals. Interactions among parasites strongly influence parasite dynamics and therefore play a major role in structuring parasite populations (both within and among hosts) as well as host populations. However, several methodological challenges remain when it comes to detecting parasite interactions. The goal of this review is to summarise current knowledge on the causes and consequences of multiparasitism and to discuss the different methods and tools that researchers have developed to study the factors that lead to multiparasitism. It also identifies new research directions to pursue.
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Affiliation(s)
- Elise Vaumourin
- UR346 Animal Epidemiology Research Unit, INRA, Saint Genès Champanelle, France. .,USC BIPAR, INRA-ANSES-ENVA, Maisons-Alfort, France.
| | - Gwenaël Vourc'h
- UR346 Animal Epidemiology Research Unit, INRA, Saint Genès Champanelle, France.
| | - Patrick Gasqui
- UR346 Animal Epidemiology Research Unit, INRA, Saint Genès Champanelle, France.
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Pearson MS, Becker L, Driguez P, Young ND, Gaze S, Mendes T, Li XH, Doolan DL, Midzi N, Mduluza T, McManus DP, Wilson RA, Bethony JM, Nausch N, Mutapi F, Felgner PL, Loukas A. Of monkeys and men: immunomic profiling of sera from humans and non-human primates resistant to schistosomiasis reveals novel potential vaccine candidates. Front Immunol 2015; 6:213. [PMID: 25999951 PMCID: PMC4419842 DOI: 10.3389/fimmu.2015.00213] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 04/18/2015] [Indexed: 11/30/2022] Open
Abstract
Schistosoma haematobium affects more than 100 million people throughout Africa and is the causative agent of urogenital schistosomiasis. The parasite is strongly associated with urothelial cancer in infected individuals and as such is designated a group I carcinogen by the International Agency for Research on Cancer. Using a protein microarray containing schistosome proteins, we sought to identify antigens that were the targets of protective IgG1 immune responses in S. haematobium-exposed individuals that acquire drug-induced resistance (DIR) to schistosomiasis after praziquantel treatment. Numerous antigens with known vaccine potential were identified, including calpain (Smp80), tetraspanins, glutathione-S-transferases, and glucose transporters (SGTP1), as well as previously uncharacterized proteins. Reactive IgG1 responses were not elevated in exposed individuals who did not acquire DIR. To complement our human subjects study, we screened for antigen targets of rhesus macaques rendered resistant to S. japonicum by experimental infection followed by self-cure, and discovered a number of new and known vaccine targets, including major targets recognized by our human subjects. This study has further validated the immunomics-based approach to schistosomiasis vaccine antigen discovery and identified numerous novel potential vaccine antigens.
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Affiliation(s)
- Mark S Pearson
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University , Cairns, QLD , Australia
| | - Luke Becker
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University , Cairns, QLD , Australia
| | - Patrick Driguez
- QIMR Berghofer Medical Research Institute , Brisbane, QLD , Australia
| | - Neil D Young
- University of Melbourne , Melbourne, VIC , Australia
| | - Soraya Gaze
- Centro de Pesquisas Rene Rachou, Oswaldo Cruz Foundation , Belo Horizonte , Brazil
| | - Tiago Mendes
- Federal University of Minas Gerais , Belo Horizonte , Brazil
| | - Xiao-Hong Li
- National Institute of Parasitic Diseases , Shanghai , China
| | - Denise L Doolan
- QIMR Berghofer Medical Research Institute , Brisbane, QLD , Australia
| | - Nicholas Midzi
- National Institutes of Health Research , Harare , Zimbabwe
| | - Takafira Mduluza
- Department of Biochemistry, University of Zimbabwe , Harare , Zimbabwe
| | - Donald P McManus
- QIMR Berghofer Medical Research Institute , Brisbane, QLD , Australia
| | - R Alan Wilson
- Department of Biology, University of York , York , UK
| | - Jeffrey M Bethony
- Department of Microbiology, Immunology and Tropical Medicine, George Washington University , Washington, DC , USA
| | | | | | | | - Alex Loukas
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University , Cairns, QLD , Australia
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Abstract
In recent years, natural product groups have been gaining prominence as possible sources of new drugs for schistosomiasis. This review attempts to update the antischistosomal natural compounds, or natural product-derived compounds, from the mid-1980s. Some of the main metabolites obtained from plants (e.g., terpenes, alkaloids, phenolic compounds and peptides) with in vitro and/or in vivo antischistosomal properties are discussed. Less thoroughly, due to scarcity of data in the literature, molecules from animals (e.g., peptides) are also described. Special mention of the anthelmintic activity against different parasitic stages of schistosomes is made; the mechanism of action of most of the metabolites is discussed, and a number of bioassay procedures are listed.
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Abstract
For decades, Praziquantel (PZQ) is the drug of choice against one of the most afflicting helminthic diseases worldwide, schistosomiasis. With respect to the fear of upcoming PZQ resistance, efforts are needed to find new chemotherapeutic options. Protein kinases (PKs) are essential molecules in signaling processes and indispensable to life. Aberrant PK functions take distinctive roles in human diseases and represent targets in chemotherapies. In schistosomes, conserved PKs were found to possess similar pivotal roles contributing not only to reproduction processes, but also to the pathology of schistosomiasis, which is closely associated to egg production. Exploiting the similarity of PKs of humans and schistosomes, PK inhibitors designed to treat human diseases may serve as lead compounds for new drugs against schistosomiasis.
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47
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Grimes JET, Croll D, Harrison WE, Utzinger J, Freeman MC, Templeton MR. The roles of water, sanitation and hygiene in reducing schistosomiasis: a review. Parasit Vectors 2015; 8:156. [PMID: 25884172 PMCID: PMC4377019 DOI: 10.1186/s13071-015-0766-9] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 02/18/2015] [Indexed: 11/10/2022] Open
Abstract
Schistosomiasis is a disease caused by infection with blood flukes of the genus Schistosoma. Transmission of, and exposure to, the parasite result from faecal or urinary contamination of freshwater containing intermediate host snails, and dermal contact with the same water. The World Health Assembly resolution 65.21 from May 2012 urges member states to eliminate schistosomiasis through preventive chemotherapy (i.e. periodic large-scale administration of the antischistosomal drug praziquantel to school-aged children and other high-risk groups), provision of water, sanitation and hygiene (WASH) and snail control. However, control measures focus almost exclusively on preventive chemotherapy, while only few studies made an attempt to determine the impact of upgraded access to safe water, adequate sanitation and good hygiene on schistosome transmission. We recently completed a systematic review and meta-analysis pertaining to WASH and schistosomiasis and found that people with safe water and adequate sanitation have significantly lower odds of a Schistosoma infection. Importantly though, the transmission of schistosomiasis is deeply entrenched in social-ecological systems, and hence is governed by setting-specific cultural and environmental factors that determine human behaviour and snail populations. Here, we provide a comprehensive review of the literature, which explores the transmission routes of schistosomes, particularly focussing on how these might be disrupted with WASH-related technologies and human behaviour. Additionally, future research directions in this area are highlighted.
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Affiliation(s)
- Jack E T Grimes
- Department of Civil and Environmental Engineering, Imperial College London, London, SW7 2AZ, UK.
| | - David Croll
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland. .,University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.
| | - Wendy E Harrison
- Schistosomiasis Control Initiative, Imperial College London, London, SW7 2AZ, UK.
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland. .,University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.
| | - Matthew C Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA.
| | - Michael R Templeton
- Department of Civil and Environmental Engineering, Imperial College London, London, SW7 2AZ, UK.
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Kleppa E, Klinge KF, Galaphaththi-Arachchige HN, Holmen SD, Lillebø K, Onsrud M, Gundersen SG, Taylor M, Ndhlovu P, Kjetland EF. Schistosoma haematobium infection and CD4+ T-cell levels: a cross-sectional study of young South African women. PLoS One 2015; 10:e0119326. [PMID: 25768005 PMCID: PMC4359034 DOI: 10.1371/journal.pone.0119326] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 01/14/2015] [Indexed: 01/23/2023] Open
Abstract
Schistosoma (S.) haematobium causes urogenital schistosomiasis and has been hypothesized to adversely impact HIV transmission and progression. On the other hand it has been hypothesized that HIV could influence the manifestations of schistosomiasis. In this cross-sectional study, we explored the association between urogenital S. haematobium infection and CD4 cell counts in 792 female high-school students from randomly selected schools in rural KwaZulu-Natal, South Africa. We also investigated the association between low CD4 cell counts in HIV positive women and the number of excreted schistosome eggs in urine. Sixteen percent were HIV positive and 31% had signs of urogenital schistosomiasis (as determined by genital sandy patches and / or abnormal blood vessels on ectocervix / vagina by colposcopy or presence of eggs in urine). After stratifying for HIV status, participants with and without urogenital schistosomiasis had similar CD4 cell counts. Furthermore, there was no significant difference in prevalence of urogenital schistosomiasis in HIV positive women with low and high CD4 cell counts. There was no significant difference in the number of eggs excreted in urine when comparing HIV positive and HIV negative women. Our findings indicate that urogenital schistosomiasis do not influence the number of circulating CD4 cells.
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Affiliation(s)
- Elisabeth Kleppa
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kari F. Klinge
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | | | - Sigve D. Holmen
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kristine Lillebø
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mathias Onsrud
- Department of Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Svein Gunnar Gundersen
- Research Unit, Sorlandet Hospital, Kristiansand, Norway
- Department of Global Development and Planning, University of Agder, Kristiansand, Norway
| | - Myra Taylor
- Discipline of Public Health Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | | | - Eyrun F. Kjetland
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
- Discipline of Public Health Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Chachage M, Geldmacher C. Immune system modulation by helminth infections: potential impact on HIV transmission and disease progression. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 828:131-49. [PMID: 25253030 DOI: 10.1007/978-1-4939-1489-0_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- Mkunde Chachage
- Department of Cellular Immunology, National Institute for Medical Research-Mbeya Medical Research Centre (NIMR-MMRC), Hospital Hill road, Mbeya, Tanzania,
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50
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Kouri V, Khouri R, Alemán Y, Abrahantes Y, Vercauteren J, Pineda-Peña AC, Theys K, Megens S, Moutschen M, Pfeifer N, Van Weyenbergh J, Pérez AB, Pérez J, Pérez L, Van Laethem K, Vandamme AM. CRF19_cpx is an Evolutionary fit HIV-1 Variant Strongly Associated With Rapid Progression to AIDS in Cuba. EBioMedicine 2015; 2:244-54. [PMID: 26137563 PMCID: PMC4484819 DOI: 10.1016/j.ebiom.2015.01.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 01/22/2015] [Accepted: 01/26/2015] [Indexed: 12/12/2022] Open
Abstract
Background Clinicians reported an increasing trend of rapid progression (RP) (AIDS within 3 years of infection) in Cuba. Methods Recently infected patients were prospectively sampled, 52 RP at AIDS diagnosis (AIDS-RP) and 21 without AIDS in the same time frame (non-AIDS). 22 patients were sampled at AIDS diagnosis (chronic-AIDS) retrospectively assessed as > 3 years infected. Clinical, demographic, virological, epidemiological and immunological data were collected. Pol and env sequences were used for subtyping, transmission cluster analysis, and prediction of resistance, co-receptor use and evolutionary fitness. Host, immunological and viral predictors of RP were explored through data mining. Findings Subtyping revealed 26 subtype B strains, 6 C, 6 CRF18_cpx, 9 CRF19_cpx, 29 BG-recombinants and other subtypes/URFs. All patients infected with CRF19 belonged to the AIDS-RP group. Data mining identified CRF19, oral candidiasis and RANTES levels as the strongest predictors of AIDS-RP. CRF19 was more frequently predicted to use the CXCR4 co-receptor, had higher fitness scores in the protease region, and patients had higher viral load at diagnosis. Interpretation CRF19 is a recombinant of subtype D (C-part of Gag, PR, RT and nef), subtype A (N-part of Gag, Integrase, Env) and subtype G (Vif, Vpr, Vpu and C-part of Env). Since subtypes D and A have been associated with respectively faster and slower disease progression, our findings might indicate a fit PR driving high viral load, which in combination with co-infections may boost RANTES levels and thus CXCR4 use, potentially explaining the fast progression. We propose that CRF19 is evolutionary very fit and causing rapid progression to AIDS in many newly infected patients in Cuba. We propose that CRF19 is evolutionary very fit, causing rapid progression to AIDS in many newly infected patients in Cuba. CRF19 is a recombinant of subtype D, subtype A and subtype G, with a subtype D protease estimated to be particularly fit. A fit protease with high viral load and co-infections, may boost RANTES levels and thus CXCR4 use, hence fast progression.
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Affiliation(s)
- Vivian Kouri
- Virology Department, Institute of Tropical Medicine Pedro Kourí, Autopista Novia del Mediodía Km 6, Marianao 13, Havana City, Cuba
| | - Ricardo Khouri
- KU Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, B-3000 Leuven, Belgium ; LIMI-LIP, Centro de Pesquisa Gonçalo Moniz, FIOCRUZ, Salvador-Bahia, Brazil
| | - Yoan Alemán
- Virology Department, Institute of Tropical Medicine Pedro Kourí, Autopista Novia del Mediodía Km 6, Marianao 13, Havana City, Cuba
| | - Yeissel Abrahantes
- Virology Department, Institute of Tropical Medicine Pedro Kourí, Autopista Novia del Mediodía Km 6, Marianao 13, Havana City, Cuba
| | - Jurgen Vercauteren
- KU Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, B-3000 Leuven, Belgium
| | - Andrea-Clemencia Pineda-Peña
- KU Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, B-3000 Leuven, Belgium ; Clinical and Molecular Infectious Diseases Group, Faculty of Sciences and Mathematics, Universidad del Rosario, Bogotá, Colombia
| | - Kristof Theys
- KU Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, B-3000 Leuven, Belgium
| | - Sarah Megens
- KU Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, B-3000 Leuven, Belgium
| | - Michel Moutschen
- AIDS Reference Center, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Nico Pfeifer
- Department of Computational Biology and Applied Algorithmics, Max Planck Institute for Informatics, Campus E1 4, 66123 Saarbrücken, Germany
| | - Johan Van Weyenbergh
- KU Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, B-3000 Leuven, Belgium
| | - Ana B Pérez
- Virology Department, Institute of Tropical Medicine Pedro Kourí, Autopista Novia del Mediodía Km 6, Marianao 13, Havana City, Cuba
| | - Jorge Pérez
- Virology Department, Institute of Tropical Medicine Pedro Kourí, Autopista Novia del Mediodía Km 6, Marianao 13, Havana City, Cuba
| | - Lissette Pérez
- Virology Department, Institute of Tropical Medicine Pedro Kourí, Autopista Novia del Mediodía Km 6, Marianao 13, Havana City, Cuba
| | - Kristel Van Laethem
- KU Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, B-3000 Leuven, Belgium
| | - Anne-Mieke Vandamme
- KU Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Clinical and Epidemiological Virology, B-3000 Leuven, Belgium ; Centro de Malária e outras Doenças Tropicais and Unidade de Microbiologia, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
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