Abstract:
Previously, we have shown that persons with human immunodeficiency virus 1 (HIV-1) infection and
reduced CD4+ T-lymphocyte counts excrete significantly fewer Schistosoma mansoni eggs than HIV-1–negative persons
with similar intensities of schistosome infections. To determine how antiretroviral therapy (ART) might affect egg
excretion, we conducted a study of HIV+ adults living in an area highly endemic for S. mansoni as they began an ART
program.FecaleggexcretionandCD4+T-lymphocytecountswereevaluatedatenrollmentaswellas2and4weeksafter
initiation of ART. Fourteen individuals who were Kato–Katz-negative at enrollment subsequently started excreting
S. mansoni eggs accompanied by a significant increase in CD4+ T lymphocytes ( P= 0.004). Study participants who were
S. mansoniegg-positiveatenrollmentandreceivedbothpraziquantelandARTalsoshowedsignificantlyincreasedCD4 +
T-lymphocyte counts compared with baseline ( P< 0.0001). Our data support a role for CD4+ T lymphocytes in
S. mansoni egg excretion.
