Hookworm infection is associated with decreased CD4+ T cell counts in HIV-infected adult Ugandans.
Most studies evaluating epidemiologic relationships between helminths and HIV have been conducted in the pre-ART era, and evidence of the impact of helminth infections on HIV disease progression remains conflicting. Less is known about helminth infection and clinical outcomes in HIV-infected adults...
Published in: | PLOS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2017
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0005634 https://doaj.org/article/c9642269934b42f48aecea5650622e8d |
id |
ftdoajarticles:oai:doaj.org/article:c9642269934b42f48aecea5650622e8d |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:c9642269934b42f48aecea5650622e8d 2023-05-15T15:13:11+02:00 Hookworm infection is associated with decreased CD4+ T cell counts in HIV-infected adult Ugandans. Bozena M Morawski Miya Yunus Emmanuel Kerukadho Grace Turyasingura Logose Barbra Andrew Mijumbi Ojok Andrew R DiNardo Stefanie Sowinski David R Boulware Rojelio Mejia 2017-05-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005634 https://doaj.org/article/c9642269934b42f48aecea5650622e8d EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5462474?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005634 https://doaj.org/article/c9642269934b42f48aecea5650622e8d PLoS Neglected Tropical Diseases, Vol 11, Iss 5, p e0005634 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005634 2022-12-31T01:43:19Z Most studies evaluating epidemiologic relationships between helminths and HIV have been conducted in the pre-ART era, and evidence of the impact of helminth infections on HIV disease progression remains conflicting. Less is known about helminth infection and clinical outcomes in HIV-infected adults receiving antiretroviral therapy (ART). We sampled HIV-infected adults for eight gastrointestinal parasites and correlated parasitic infection with demographic predictors, and clinical and immunologic outcomes. Contrasting with previous studies, we measured parasitic infection with a quantitative, highly sensitive and specific polymerase chain reaction (PCR) method. This cohort study enrolled HIV-infected Ugandans from August-September 2013 in Mbale, Uganda and collected stool and blood samples at enrollment. Real-time PCR quantified stool: Ascaris lumbricoides, Ancylostoma duodenale, Necator americanus, Strongyloides stercoralis, Trichuris trichiura, Cryptosporidium spp., Entamoeba histolytica, and Giardia intestinalis infection. Generalized linear models assessed relationships between parasitic infection and clinical or demographic data. 35% of participants (71/202) tested positive for ≥1 helminth, mainly N. americanus (55/199, 28%), and 4.5% (9/202) were infected with ≥2 stool parasites. Participants with hookworm infection had lower average CD4+ cell counts (-94 cells/mcL, 95%CI: -141, -48 cells/mcL; p<0.001) after adjustment for sex, CD4+ nadir at clinic entry, and time on ART. The high prevalence of parasitic infection and correlation with decreased CD4+ concentrations highlight the need to re-examine the effects of invasive helminth co-infection in rural, HIV-infected populations in the era of widely available ART. Elucidating the relationship between hookworm infection and immune recovery could provide opportunities for health optimization, e.g. integrated deworming, in these vulnerable populations. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 5 e0005634 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Bozena M Morawski Miya Yunus Emmanuel Kerukadho Grace Turyasingura Logose Barbra Andrew Mijumbi Ojok Andrew R DiNardo Stefanie Sowinski David R Boulware Rojelio Mejia Hookworm infection is associated with decreased CD4+ T cell counts in HIV-infected adult Ugandans. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Most studies evaluating epidemiologic relationships between helminths and HIV have been conducted in the pre-ART era, and evidence of the impact of helminth infections on HIV disease progression remains conflicting. Less is known about helminth infection and clinical outcomes in HIV-infected adults receiving antiretroviral therapy (ART). We sampled HIV-infected adults for eight gastrointestinal parasites and correlated parasitic infection with demographic predictors, and clinical and immunologic outcomes. Contrasting with previous studies, we measured parasitic infection with a quantitative, highly sensitive and specific polymerase chain reaction (PCR) method. This cohort study enrolled HIV-infected Ugandans from August-September 2013 in Mbale, Uganda and collected stool and blood samples at enrollment. Real-time PCR quantified stool: Ascaris lumbricoides, Ancylostoma duodenale, Necator americanus, Strongyloides stercoralis, Trichuris trichiura, Cryptosporidium spp., Entamoeba histolytica, and Giardia intestinalis infection. Generalized linear models assessed relationships between parasitic infection and clinical or demographic data. 35% of participants (71/202) tested positive for ≥1 helminth, mainly N. americanus (55/199, 28%), and 4.5% (9/202) were infected with ≥2 stool parasites. Participants with hookworm infection had lower average CD4+ cell counts (-94 cells/mcL, 95%CI: -141, -48 cells/mcL; p<0.001) after adjustment for sex, CD4+ nadir at clinic entry, and time on ART. The high prevalence of parasitic infection and correlation with decreased CD4+ concentrations highlight the need to re-examine the effects of invasive helminth co-infection in rural, HIV-infected populations in the era of widely available ART. Elucidating the relationship between hookworm infection and immune recovery could provide opportunities for health optimization, e.g. integrated deworming, in these vulnerable populations. |
format |
Article in Journal/Newspaper |
author |
Bozena M Morawski Miya Yunus Emmanuel Kerukadho Grace Turyasingura Logose Barbra Andrew Mijumbi Ojok Andrew R DiNardo Stefanie Sowinski David R Boulware Rojelio Mejia |
author_facet |
Bozena M Morawski Miya Yunus Emmanuel Kerukadho Grace Turyasingura Logose Barbra Andrew Mijumbi Ojok Andrew R DiNardo Stefanie Sowinski David R Boulware Rojelio Mejia |
author_sort |
Bozena M Morawski |
title |
Hookworm infection is associated with decreased CD4+ T cell counts in HIV-infected adult Ugandans. |
title_short |
Hookworm infection is associated with decreased CD4+ T cell counts in HIV-infected adult Ugandans. |
title_full |
Hookworm infection is associated with decreased CD4+ T cell counts in HIV-infected adult Ugandans. |
title_fullStr |
Hookworm infection is associated with decreased CD4+ T cell counts in HIV-infected adult Ugandans. |
title_full_unstemmed |
Hookworm infection is associated with decreased CD4+ T cell counts in HIV-infected adult Ugandans. |
title_sort |
hookworm infection is associated with decreased cd4+ t cell counts in hiv-infected adult ugandans. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005634 https://doaj.org/article/c9642269934b42f48aecea5650622e8d |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 5, p e0005634 (2017) |
op_relation |
http://europepmc.org/articles/PMC5462474?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005634 https://doaj.org/article/c9642269934b42f48aecea5650622e8d |
op_doi |
https://doi.org/10.1371/journal.pntd.0005634 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
11 |
container_issue |
5 |
container_start_page |
e0005634 |
_version_ |
1766343772224880640 |