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Schistosomiasis and Infection with Human Immunodeficiency Virus 1 in Rural Zimbabwe: Systemic Inflammation during Co-infection and after Treatment for Schistosomiasis

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  • 1 Department of Clinical Immunology, Aarhus University Hospital, Skejby Sygehus, Aarhus, Denmark; Department of Clinical Immunology, Rigshospitalet, Copenhagen, Denmark; The Centre of Inflammation and Metabolism at the Department of Infectious Diseases, Rigshospitalet, Faculty of Health Sciences, and Cluster of International Health, University of Copenhagen, Denmark; National Institute of Health Research, Harare, Zimbabwe; Department of Immunology, College of Health Sciences, and Department of Medical Microbiology, University of Zimbabwe, Harare, Zimbabwe; Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands; Biomedical Research and Training Institute, Harare, Zimbabwe, London School of Hygiene and Tropical Medicine, London, United Kingdom

We previously reported that treatment for schistosomiasis in persons infected with human immunodeficiency virus 1 (HIV-1) attenuated HIV replication as measured by plasma HIV RNA. We investigated systemic inflammation as measured by plasma levels of soluble tumor necrosis factor-α receptor II (sTNF-rII), interleukin-8, (IL-8), and IL-10 during schistosomiasis and HIV co-infection and after schistosomiasis treatment. The cohort was composed of 378 persons who were or were not infected with HIV-1, Schistosoma haematobium, or S. mansoni. Schistosomiasis-infected persons were randomized to receive praziquantel (40 mg/kg) at baseline or at the three-month follow-up. sTNF-rII and IL-8 were positively associated with schistosomiasis intensity as measured by circulating anodic antigen (CAA), regardless of HIV status. Interleukin-10 was positively associated with CAA in HIV-negative participants. IL-8 levels were higher in S. mansoni-infected individuals. Treatment for schistosomiasis caused a decrease in levels of sTNF-rII (P < 0.05) and IL-10 (P < 0.001). Our results indicate that schistosomiasis treatment may attenuate HIV replication by decreasing systemic inflammation.

Author Notes

Reprint requests: Christian Erikstrup, Department of Clinical Immunology, Aarhus University Hospital, Skejby Sygehus, Brendstrup-gaardsvej 100, DK-8200 Aarhus N, Denmark.
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