Association between CD4 + T-Lymphocyte counts and fecal excretion of schistosoma mansoni eggs in patients coinfected with S. mansoni and Human Immunodeficiency Virus before and after Initiation of antiretroviral therapy

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.