Studies on schistosomiasis in western Kenya .1. Evidence for immune-facilitated excretion of schistosome eggs from patients with Schistosoma mansoni and human immunodeficiency virus coinfections
Studies on schistosomiasis in western Kenya .1. Evidence for immune-facilitated excretion of schistosome eggs from patients with Schistosoma mansoni and human immunodeficiency virus coinfections
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DOI：
10.4269/ajtmh.1997.56.515
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发表时间：
1997-05-01
影响因子：
3.3
通讯作者：
Secor, WE
中科院分区：
文献类型：
--
作者：
Karanja, DMS;Colley, DG;Secor, WE
肯尼亚基苏木镇的洗车工人每天暴露在维多利亚湖的水中数小时，其中含有感染了曼氏血吸虫的菲氏生物phalaria pheifferi蜗牛。这导致血吸虫病高度流行，这些人的粪便中卵的浓度非常高（平均+/- SD =每克粪便1469 +/- 1581个卵）。这些血吸虫病患者的粪卵计数，而不是循环阴极抗原（CCA）水平，根据患者对人类免疫缺陷病毒（HIV）的血清阳性而有显著差异。感染曼氏梭菌且HIV血清阳性的患者CCA水平相似，但排泄的卵子（643 +/- 622 EPG, n = 16）少于HIV血清感染未阳性的患者（1,891 +/- 1,779 EPG, n = 37） （P = 0.009）。血清阴性组的卵子排泄比（EPG/CCA）也显著高于血清阳性组。血清阳性组卵子排泄率与CD4（+）淋巴细胞百分比呈显著相关。这些观察结果与血吸虫卵通过必要的功能性免疫反应促进离开人类宿主的假设是一致的，并且随着外周血CD4（+）细胞水平的降低，这一过程的效力在合并感染HIV的血吸虫病患者中降低。
Persons employed as vehicle washers in the town of Kisumu, Kenya are exposed for several hours each day to water in Lake Victoria that contains Schistosoma mansoni-infected Biomphalaria pheifferi snails. This results in a focus of high endemicity for schistosomiasis and these persons have very high concentrations of eggs in their feces (mean +/- SD = 1,469 +/- 1,581 eggs per gram [EPG] of feces). Fecal egg counts, but not circulating cathodic antigen (CCA) levels, in these schistosomiasis patients differed strikingly based on the patient's seropositivity for human immunodeficiency virus (HIV). Patients who were infected with S. mansoni and were seropositive for HIV had similar levels of CCA but excreted fewer eggs (643 +/- 622 EPG; n = 16) than individuals who were not seropositive for HIV infection (1,891 +/- 1,779 EPG; n = 37) (P = 0.009). Egg excretion ratios (EPG/CCA) of the seronegative group were also significantly higher than those of the seropositive group. Those in the seropositive group showed a significant correlative relationship between egg excretion ratios and CD4(+) lymphocyte percentages. These observations are compatible with the hypothesis that schistosome eggs exit the human host through the requisite facilitation of functional immune responses, and that the efficacy of this process decreases in schistosomiasis patients co-infected with HIV as their peripheral blood CD4(+) cell levels decrease.