Impact of schistosome infection on long-term HIV/AIDS outcomes

Soledad Colombe, Samuel E. Kalluvya, Claudia J. de Dood, Pytsje T. Hoekstra, Govert J. van Dam, Paul L. A. M. Corstjens, John M. Changalucha, Jennifer A. Downs

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Africa bears the burden of approximately 7001 seroconversion on the speed of HIV-1 disease progression, as measured by the outcome CD4+ T-cell (CD4) counts textless350 cells/μL and/or death. We hypothesized that people who had been infected with Schistosoma spp. at the time they acquired HIV-1 infection would have impaired antiviral immune response, thus leading them to progress twice as fast to a CD4 count less than 350 cells/μL or death than would people who had been free of schistosomes at time of HIV-1 seroconversion. METHODS AND PRINCIPAL FINDINGS: We conducted a longitudinal study in Tanzania from 2006 to 2017 using stored blood spot samples, demographic surveillance and sero-survey data from the community, and a review of clinical charts. A competing risk analysis was performed to look at the difference in time to reaching CD4 counts textless 350 cells/μL and/or death in HIV-1-infected people who were infected versus not infected with Schistosoma spp. at time of HIV-1 seroconversion. We found an 82subHazard Ratio = 0.18[0.068,0.50], p = 0.001) after adjusting for age, occupation, clinic attendance and time-dependent covariates. CONCLUSIONS: Our study demonstrates that people with schistosome infection at the time of HIV-seroconversion develop adverse HIV outcomes more slowly than those without. The findings are contrary to our original hypothesis. Our current longitudinal findings suggest complex interactions between HIV-1 and schistosome co-infections that may be modulated over time. We urge new immunological studies to investigate the long-term impact of schistosome infection on HIV-1 viral load and CD4 counts as well as related immunologic pathways.
Original languageEnglish
JournalPLoS Neglected Tropical Diseases
Issue number7
Pages (from-to)e0006613
Publication statusPublished - 1-Jul-2018


  • Acquired Immunodeficiency Syndrome
  • Adult
  • Animals
  • CD4 Lymphocyte Count
  • Coinfection
  • Female
  • HIV Infections
  • HIV-1
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Schistosoma
  • Schistosomiasis
  • Tanzania


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