摘要
Background:Animal studies have demonstrated that functional immune responses,as determined by the levels of CD4+cell counts and anti-schistosome antibodies responses,determine the efficacy of praziquantel.Based on this evidence,it has been hypothesised that the immunodeficiency effects of the human immunodeficiency virus(HIV)-1 infection may affect the efficacy of praziquantel in co-infected human hosts.Thus,the present study assessed the efficacy of praziquantel by comparing parasitological cure rates and the reduction in infection intensity in HIV-1 seronegative individuals infected with S.mansoni and HIV-1 seropositive individuals co-infected with S.mansoni,following treatment with a single oral dose of praziquantel.Methods:This was a prospective longitudinal study which included,at baseline,555 S.mansoni infected adults aged 21-55 years,who were either co-infected or not with HIV-1 and who lived in fishing villages along Lake Victoria in Northwest Tanzania.These individuals were treated with a single oral dose of praziquantel(40 mg/kg)and,at 12 weeks,single stool samples were obtained and examined for S.mansoni eggs using the Kato-Katz technique.Finger prick and venous blood samples were collected for HIV-1 screening and CD4+cell quantification.Results:The parasitological cure rate did not differ significantly from the HIV-1 serostatus(P=0.12):among the co-infected individuals,the cure rate was 48.3%(14/29),and among the individuals infected only with S.mansoni,the cure rate was 62.6%(329/526).The egg reduction rate did not vary with the HIV-1 serostatus(P=0.22):77.22%for HIV-1 seronegative and 75%for HIV-1 seropositive individuals.The level of CD4^(+) cell counts(median 228 cells/μL:range 202-380 cells)did not influence the cure rate(P=0.23)or the reduction in the intensity of the infection(P=0.37).Conclusion:The HIV-1 infection per se or its moderate immunodeficiency effects,demonstrated by the range of CD4^(+) cell counts observed in co-infected individuals,did not affect praziquantel efficacy,as measured by the parasitological cure rate and the reduction in intensity of infection in the present study cohort.
基金
This work was supported by Training Health Researchers into Vocational Excellence in East Africa(THRiVE),grant number 087540,funded by the Wellcome Trust.Its contents are solely the responsibility of the authors anddo not necessarily reflect the official views of the supporting offices
DWD and HDM received additional funds from the Cambridge-Africa Alborada Research Fund,we acknowledge its support
HDM received additionalfunding support from the Dan David Prize Scholarship,Tel Aviv University,Israel
HDM also received financial support from TDR,the Special Programme for Research and Training in Tropical Diseases,co-sponsored by UNICEF,UNDP,the World Bank and the WHO,we acknowledge their support.
