Associations between helminth infection and CD4(+) T cell count, viral load and cytokine responses in HIV-1-infected Ugandan adults


Elliott, AM; Mawa, PA; Joseph, S; Namujju, PB; Kizza, M; Nakiyingi, JS; Watera, C; Dunne, DW; Whitworth, JAG; (2003) Associations between helminth infection and CD4(+) T cell count, viral load and cytokine responses in HIV-1-infected Ugandan adults. Transactions of the Royal Society of Tropical Medicine and Hygiene, 97 (1). pp. 103-108. ISSN 0035-9203 DOI: 10.1016/S0035-9203(03)90040-X

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Abstract

It has been proposed that helminth infection may exacerbate HIV progression by promoting activation of 'type 2' immune responses. To examine this hypothesis, we investigated helminth infection in a cohort of HIV-1-seropositive adults in Entebbe, Uganda, during November 1999 to January 2000. Individuals with helminths were treated. At enrolment, after 5 weeks and after 4 months, CD4(+) and CD8(+) T cell counts and viral load were measured. Cytokine responses (interferon [IFN]-gamma, interleukin [IL]-2, IL-4 and IL-5) to Schistosoma mansoni adult worm antigen (SWA), Mycobacterium tuberculosis culture filtrate proteins (CFPs) and phytohaemagglutinin (PHA) were measured in a whole blood assay. At baseline, CD4(+) T cell counts and CD4(+):CD8(+) ratios were higher in individuals with helminths than in those without (median CD4(+) T cell counts 467/muL and 268/muL, respectively, P = 0.005). Viral load was lower among those with helminths but this was not statistically significant. During follow-up, CD4(+) T cell counts and cytokine responses to PHA fell among individuals without helminths. Among those treated for helminths, CD4(+) counts remained stable. Viral loads showed a transient increase at 5 weeks, which was more marked among those treated for helminths, but the levels at 4 months were similar to baseline in both groups. Among those with schistosomiasis, IFN-gamma and IL-2 responses to CFP, and IL-2 and IL-4 responses to PHA declined but there was a sustained increase in cytokine responses to SWA following treatment. These data do not support the hypothesis that helminth infection exacerbates HIV infection. The possibility that chronic helminth infection may suppress HIV replication and that effects on HIV replication may vary during helminth infection and treatment should be considered.

Item Type: Article
Keywords: HIV, helminths, immunobiology, T cells, cytokine responses, Uganda, placebo-controlled trial, tumor necrosis factor, factor-kappa-, b, schistosoma-mansoni, mycobacterium-tuberculosis, hiv-1, infection, activation, pathogenesis, antigen, binding, Adult, CD4 Lymphocyte Count, CD4-Positive T-Lymphocytes, immunology, virology, Cohort Studies, Cytokines, metabolism, Female, HIV Infections, immunology, parasitology, HIV Seropositivity, HIV-1, Helminthiasis, immunology, therapy, virology, Human, Male, Support, Non-U.S. Gov't, Viral Load
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Immunology and Infection
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 12886815
Web of Science ID: 184231000027
URI: http://researchonline.lshtm.ac.uk/id/eprint/16098

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