HIV target cells in Schistosoma haematobium-infected female genital mucosa

Jourdan PM, Holmen SD, Gundersen SG, Roald B, Kjetland EF Journal title: The American journal of tropical medicine and hygiene Am. J. Trop. Med. Hyg. 2011 Dec;85(6):1060-4 PMID: 22144444 Article on PubMed: http://www.ncbi.nlm.nih.gov/pubmed/22144444 Abstract The parasite Schistosoma haematobium frequently causes genital lesions in women and could increase the risk of human immunodeficiency virus (HIV) transmission. This study quantifies the HIV target cells in schistosome-infected female genital mucosa. Cervicovaginal biopsies with and without schistosomiasis were immunostained for quantification of CD4(+) T lymphocytes (CD3, CD8), macrophages (CD68), and dendritic Langerhans cells (S100 protein). We found significantly higher densities of genital mucosal CD4(+) T lymphocytes and macrophages surrounding schistosome ova compared with cervicovaginal mucosa without ova (P = 0.034 and P = 0.018, respectively). We found no increased density of Langerhans cells (P = 0.25). This study indicates that S. haematobium may significantly increase the density of HIV target cells (CD4(+) T lymphocytes and macrophages) in the female genitals, creating a beneficial setting for HIV transmission. Further studies are needed to confirm these findings and to evaluate the effect of anti-schistosomal treatment on female genital schistosomiasis....

Increased vascularity in cervicovaginal mucosa with Schistosoma haematobium infection

Jourdan PM, Roald B, Poggensee G, Gundersen SG, Kjetland EF Journal title: PLoS neglected tropical diseases PLoS Negl Trop Dis 2011 Jun;5(6):e1170 PMID: 21666790 Article on PubMed: http://www.ncbi.nlm.nih.gov/pubmed/21666790 Abstract BACKGROUND: Close to 800 million people in the world are at risk of schistosomiasis, 85 per cent of whom live in Africa. Recent studies have indicated that female genital schistosomiasis might increase the risk of human immunodeficiency virus (HIV) infection. The aim of this study is to quantify and analyse the characteristics of the vasculature surrounding Schistosoma haematobium ova in the female genital mucosa. METHODOLOGY/PRINCIPAL FINDINGS: Cervicovaginal biopsies with S. haematobium ova (n=20) and control biopsies (n=69) were stained with immunohistochemical blood vessel markers CD31 and von Willebrand Factor (vWF), which stain endothelial cells in capillary buds and established blood vessels respectively. Haematoxylin and eosin (HE) were applied for histopathological assessment. The tissue surrounding S. haematobium ova had a higher density of established blood vessels stained by vWF compared to healthy controls (p=0.017). Immunostain to CD31 identified significantly more granulation tissue surrounding viable compared to calcified ova (p=0.032), and a tendency to neovascularisation in the tissue surrounding viable ova compared to healthy cervical mucosa (p=0.052). CONCLUSIONS/SIGNIFICANCE: In this study female genital mucosa with S. haematobium ova was significantly more vascularised compared to healthy cervical tissue. Viable parasite ova were associated with granulation tissue rich in sprouting blood vessels. Although the findings of blood vessel proliferation in this study may be a step to better understand the implications of S. haematobium infection, further studies are needed to explore the biological, clinical and epidemiological features of female genital schistosomiasis and its possible...

The effects of genital schistosoma haematobium on human papillomavirus and the development of cervical neoplasia after five years in a Zimbabwean population

Kjetland EF, Ndhlovu PD, Mduluza T, Deschoolmeester V, Midzi N, Gomo E, Gwanzura L, Mason PR, Vermorken JB, Friis H, Gundersen SG, Baay MF Journal title: European journal of gynaecological oncology Eur. J. Gynaecol. Oncol. 2010;31(2):169-73 PMID: 20527233 Article on PubMed: http://www.ncbi.nlm.nih.gov/pubmed/20527233 Abstract BACKGROUND: High-risk human papillomavirus (HPV) is responsible for cervical cancer and genital Schistosoma haematobium infection has been hypothesized to be an additional co-factor or even an independent risk factor for cervical neoplasia. The present study aimed to investigate the impact of schistosomiasis on HPV persistence and development of cell atypia in a group of rural Zimbabwean women with confirmed high-risk HPV. METHODS: A five-year follow-up was done among women previously included in a study on genital schistosomiasis. Women who had high-risk HPV at baseline were invited after 5 years for examination of cell atypia, genital schistosomiasis, and high-risk HPV. Both vaginal lavage samples (low-cost) and cervix brush samples (high-cost) were obtained for further analysis. RESULTS: Thirty-seven women were re-examined. Genital Schistosoma haematobium of a minimum of five years’ duration was associated with the development high-grade squamous intraepithelial neoplasia, but not with persistent high-risk HPV. There was a high concordance between the brush and vaginal lavage (96.3% agreement, kappa 0.93); however, the number of beta-globin negative vaginal lavage samples was unacceptably high. CONCLUSIONS: Findings warrant an exploration in a larger longitudinal study where a vaginal swab should be explored....

The first community-based report on the effect of genital Schistosoma haematobium infection on female fertility

Kjetland EF, Kurewa EN, Mduluza T, Midzi N, Gomo E, Friis H, Gundersen SG, Ndhlovu PD Journal title: Fertility and sterility Fertil. Steril. 2010 Sep;94(4):1551-3 PMID: 20149365 Article on PubMed: http://www.ncbi.nlm.nih.gov/pubmed/20149365 Abstract A cross-sectional study in an Schistosoma haematobium endemic area of rural Zimbabwe examined 483 resident women between the ages of 20 and 49 years who were interviewed about fertility. S. haematobium ova in genital tissue was found to be significantly associated with infertility....

Schistosomiasis PCR in vaginal lavage as an indicator of genital Schistosoma haematobium infection in rural Zimbabwean women

Kjetland EF, Hove RJ, Gomo E, Midzi N, Gwanzura L, Mason P, Friis H, Verweij JJ, Gundersen SG, Ndhlovu PD, Mduluza T, Van Lieshout L Journal title: The American journal of tropical medicine and hygiene Am. J. Trop. Med. Hyg. 2009 Dec;81(6):1050-5 PMID: 19996436 Article on PubMed: http://www.ncbi.nlm.nih.gov/pubmed/19996436 Abstract Schistosoma real-time polymerase chain reaction (PCR) is sensitive and specific in urine and stool. We sought to explore the relationship between genital schistosomiasis and the Schistosoma PCR in women. PCR was run on 83 vaginal lavage samples from a rural Zimbabwean population. Women underwent clinical and colposcopic investigations, analyses for sexually transmitted infections, and genital schistosomiasis. Thirty samples were positive for Schistosoma PCR: 12 were strong and 18 were weak positive. Sensitivity (67%) and specificity (83%) were best in women below the age of 25 years. A positive schistosome PCR result was associated with S. haematobium ova in genital tissue, so-called sandy patches, and bleeding. Prevalence determined by PCR were lower and real-time PCR values were weaker in older women. The presence of Schistosoma DNA may be greater in the recent lesions (e.g., in younger women). For diagnosis in rural areas and in large studies, Schistosoma PCR could become a supplement to gynecologic examinations....

Africa’s 32 cents solution for HIV/AIDS

Hotez PJ, Fenwick A, Kjetland EF Journal title: PLoS neglected tropical diseases PLoS Negl Trop Dis 2009;3(5):e430 PMID: 19479041 Article on PubMed: http://www.ncbi.nlm.nih.gov/pubmed/19479041 Abstract...