Open Access Scoping Review

Epidemiology and interactions of Human Immunodeficiency Virus – 1 and Schistosoma mansoni in sub-Saharan Africa

Humphrey D Mazigo1234*, Fred Nuwaha2, Shona Wilson4, Safari M Kinung'hi3, Domenica Morona1, Rebecca Waihenya5, Jorg Heukelbach6 and David W Dunne4

Author Affiliations

1 Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania

2 Department of Environmental Health and Communicable Disease Control, School of Public Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda

3 National Institute for Medical Research, Mwanza Research Centre, P.O. Box 1462, Mwanza, Tanzania

4 Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP, UK

5 Department of Zoology, Faculty of Science, Jomo Kenyatta University of Agriculture and Technology, P.O. Box 62,000, 00200, Nairobi, Kenya

6 Department of Community Health, School of Medicine, Federal University of Ceará, Ceará, Brazil

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Infectious Diseases of Poverty 2013, 2:2  doi:10.1186/2049-9957-2-2

Published: 24 January 2013

Abstract

Human Immunodeficiency Virus-1/AIDS and Schistosoma mansoni are widespread in sub-Saharan Africa and co-infection occurs commonly. Since the early 1990s, it has been suggested that the two infections may interact and potentiate the effects of each other within co-infected human hosts. Indeed, S. mansoni infection has been suggested to be a risk factor for HIV transmission and progression in Africa. If so, it would follow that mass deworming could have beneficial effects on HIV-1 transmission dynamics. The epidemiology of HIV in African countries is changing, shifting from urban to rural areas where the prevalence of Schistosoma mansoni is high and public health services are deficient. On the other side, the consequent pathogenesis of HIV-1/S. mansoni co-infection remains unknown. Here we give an account of the epidemiology of HIV-1 and S. mansoni, discuss co-infection and possible biological causal relationships between the two infections, and the potential impact of praziquantel treatment on HIV-1 viral loads, CD4+ counts and CD4+/CD8+ ratio. Our review of the available literature indicates that there is evidence to support the hypothesis that S. mansoni infections can influence the replication of the HIV-1, cell-to-cell transmission, as well as increase HIV progression as measured by reduced CD4+ T lymphocytes counts. If so, then deworming of HIV positive individuals living in endemic areas may impact on HIV-1 viral loads and CD4+ T lymphocyte counts.

Keywords:
Schistosoma mansoni; HIV-1; Co-infections; Immunological interactions; Deworming