SHORT REPORT: EVALUATION OF HEPATIC FIBROSIS IN PERSONS CO-INFECTED WITH SCHISTOSOMA MANSONI AND HUMAN IMMUNODEFICIENCY VIRUS 1

PAULINE N. M. MWINZI Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya; Ministry of Health, Nairobi, Kenya; Department of Zoology, Kenyatta University, Nairobi, Kenya; Center for Tropical and Emerging Global Diseases and the Department of Microbiology, University of Georgia, Athens, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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DIANA M. S. KARANJA Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya; Ministry of Health, Nairobi, Kenya; Department of Zoology, Kenyatta University, Nairobi, Kenya; Center for Tropical and Emerging Global Diseases and the Department of Microbiology, University of Georgia, Athens, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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IRERI KAREKO Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya; Ministry of Health, Nairobi, Kenya; Department of Zoology, Kenyatta University, Nairobi, Kenya; Center for Tropical and Emerging Global Diseases and the Department of Microbiology, University of Georgia, Athens, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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PHILLIP W. MAGAK Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya; Ministry of Health, Nairobi, Kenya; Department of Zoology, Kenyatta University, Nairobi, Kenya; Center for Tropical and Emerging Global Diseases and the Department of Microbiology, University of Georgia, Athens, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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ALLOYS S. S. ORAGO Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya; Ministry of Health, Nairobi, Kenya; Department of Zoology, Kenyatta University, Nairobi, Kenya; Center for Tropical and Emerging Global Diseases and the Department of Microbiology, University of Georgia, Athens, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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DANIEL G. COLLEY Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya; Ministry of Health, Nairobi, Kenya; Department of Zoology, Kenyatta University, Nairobi, Kenya; Center for Tropical and Emerging Global Diseases and the Department of Microbiology, University of Georgia, Athens, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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W. EVAN SECOR Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya; Ministry of Health, Nairobi, Kenya; Department of Zoology, Kenyatta University, Nairobi, Kenya; Center for Tropical and Emerging Global Diseases and the Department of Microbiology, University of Georgia, Athens, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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To investigate whether infection with human immunodeficiency virus 1 (HIV-1) affects fibrosis development in patients infected with Schistosoma mansoni, we evaluated schistosomiasis-induced pathology in the livers of Kenyan patients co-infected with HIV-1. Compared with persons with schistosomiasis alone (n = 58), there were no significant differences in distribution of ultrasound-detectable pathology in persons with HIV-1 co-infection (n = 23). Similarly, serum aspartate aminotransferase levels were not significantly different in HIV-1+ individuals. Hepatic fibrosis was associated with significantly decreased CD4+ T cell counts, even in the absence of HIV-1 infection. These data suggest that HIV-1 co-infection does not significantly alter the proportion of patients experiencing schistosomiasis-induced fibrosis, but pathology associated with S. mansoni infections leads to CD4+ T cell reductions and thereby may exacerbate the effects of HIV-1 in co-infected individuals.

Author Notes

  • 1

    Colley DG, Garcia AA, Lambertucci JR, Parra JC, Katz N, Rocha RS, Gazzinelli G, 1986. Immune responses during human schistosomiasis. XII. Differential responsiveness in patients with hepatosplenic disease. Am J Trop Med Hyg 35 :793–802.

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  • 2

    Buchanan RD, Fine DP, Colley DG, 1973. Schistosoma mansoni: infection in mice depleted of thymus-dependent lymphocytes. II. Pathology: Altered pathogenesis. Am J Pathol 71 :208–218.

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  • 3

    Lucas S, Musallam R, Bain J, Hassounah O, Bickle Q, Doenhoff M, 1980. The pathological effects of immunosuppression of Schistosoma mansoni-infected mice, with particular reference to survival and hepatotoxicity after thymectomy and treatment with antithymocyte serum, and treatment with hydrocortisone acetate. Trans R Soc Trop Med Hyg 74 :633–643.

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  • 4

    Karanja DMS, Colley DG, Nahlen BL, Ouma JH, Secor WE, 1997. Studies on schistosomiasis in western Kenya. I. Evidence for immune-facilitated excretion of schistosome eggs from patients with Schistosoma mansoni and human immunodeficiency virus co-infections. Am J Trop Med Hyg 56 :515–521.

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  • 5

    Richter J, Hatz C, Campagne G, Bergquist NR, Jenkins JM, 2000. Ultrasound in Schistosomiasis: A Practical Guide to the Standardized Use of Ultrasonography for the Assessment of Schistosomiasis-Related Morbidity. Geneva: World Health Organization. (http://www.who.int/tdr/publications/publications/pdf/ultrasound.pdf).

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  • 6

    Colley DG, Katz N, Rocha RS, Abrantes W, da Silva AL, Gazzinelli G, 1983. Immune responses during human schistosomiasis mansoni. IX. T-lymphocyte subset analysis by mono-clonal antibodies in hepatosplenic disease. Scand J Immunol 17 :297–302.

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