Kleppa Elisabeth, Ramsuran Veron, Zulu Siphosenkosi, Karlsen Gunn Hege, Bere Alfred, Passmore Jo-Ann S, Ndhlovu Patricia, Lillebø Kristine, Holmen Sigve D, Onsrud Mathias, Gundersen Svein Gunnar, Taylor Myra, Kjetland Eyrun F, Ndung'u Thumbi
Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital (OUH), Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
HIV Pathogenesis Programme, Nelson R Mandela School of Medicine, University of KwaZulu-Natal (UKZN), Durban, South Africa.
PLoS One. 2014 Jun 4;9(6):e98593. doi: 10.1371/journal.pone.0098593. eCollection 2014.
Schistosoma haematobium is a waterborne parasite that may cause female genital schistosomiasis (FGS), characterized by genital mucosal lesions. There is clinical and epidemiological evidence for a relationship between FGS and HIV. We investigated the impact of FGS on HIV target cell density and expression of the HIV co-receptor CCR5 in blood and cervical cytobrush samples. Furthermore we evaluated the effect of anti-schistosomal treatment on these cell populations.
The study followed a case-control design with post treatment follow-up, nested in an on-going field study on FGS.
Blood and cervical cytobrush samples were collected from FGS negative and positive women for flow cytometry analyses. Urine samples were investigated for schistosome ova by microscopy and polymerase chain reaction (PCR).
FGS was associated with a higher frequency of CD14+ cells (monocytes) in blood (11.5% in FGS+ vs. 2.2% in FGS-, p = 0.042). Frequencies of CD4+ cells expressing CCR5 were higher in blood samples from FGS+ than from FGS- women (4.7% vs. 1.5%, p = 0.018). The CD14+ cell population decreased significantly in both compartments after anti-schistosomal treatment (p = 0.043). Although the frequency of CD4+ cells did not change after treatment, frequencies of CCR5 expression by CD4+ cells decreased significantly in both compartments (from 3.4% to 0.5% in blood, p = 0.036; and from 42.4% to 5.6% in genital samples, p = 0.025).
The results support the hypothesis that FGS may increase the risk of HIV acquisition, not only through damage of the mucosal epithelial barrier, but also by affecting HIV target cell populations, and that anti-schistosomal treatment can modify this.
埃及血吸虫是一种通过水传播的寄生虫，可导致女性生殖器血吸虫病（FGS），其特征为生殖器黏膜病变。有临床和流行病学证据表明FGS与HIV之间存在关联。我们研究了FGS对血液和宫颈细胞刷样本中HIV靶细胞密度及HIV共受体CCR5表达的影响。此外，我们评估了抗血吸虫治疗对这些细胞群体的作用。
本研究采用病例对照设计，并进行治疗后随访，该研究嵌套于一项正在进行的关于FGS的现场研究中。
采集FGS阴性和阳性女性的血液及宫颈细胞刷样本，进行流式细胞术分析。通过显微镜检查和聚合酶链反应（PCR）检测尿液样本中的血吸虫卵。
FGS与血液中CD14+细胞（单核细胞）的较高频率相关（FGS阳性组为11.5%，FGS阴性组为2.2%，p = 0.042）。FGS阳性女性血液样本中表达CCR5的CD4+细胞频率高于FGS阴性女性（4.7%对1.5%，p = 0.018）。抗血吸虫治疗后，两个部位的CD14+细胞群体均显著减少（p = 0.043）。尽管治疗后CD4+细胞频率未发生变化，但两个部位CD4+细胞表达CCR5的频率均显著降低（血液中从3.4%降至0.5%，p = 0.036；生殖器样本中从42.4%降至5.6%，p = 0.025）。
结果支持以下假设，即FGS可能不仅通过破坏黏膜上皮屏障，还通过影响HIV靶细胞群体来增加感染HIV的风险，且抗血吸虫治疗可以改变这种情况。
