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

Christian Erikstrup 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

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Per Kallestrup 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

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Rutendo B. L. Zinyama-Gutsire 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

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Exnevia Gomo 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

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Govert J. van Dam 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

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André M. Deelder 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

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Anthony E. Butterworth 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

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Bente Klarlund Pedersen 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

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Sisse R. Ostrowski 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

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Jan Gerstoft 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

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Henrik Ullum 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

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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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