Title: Expression of the CCR5 HIV co-receptor in
women with genital schistosomiasis
Authors: Kleppa E, Ramsuran V, Zulu S, Karlsen GH, Bere A, Passmore JA, Ndhlovu P, Lillebo K, Holmen SD, Onsrud M, Gundersen SG, Taylor M, Kjetland EF, Ndung'u T.
Journal: 16th ICID Abstracts / International Journal of Inf,21S:1-460 (2014)
Background: Female genital schistosomiasis (FGS) is characterised by genital mucosal lesions called sandy patches causing inflammation and bleeding. Epidemiological evidence of a relationship between FGS and HIV has been found, but the biological mechanism behind the association is unknown. Heterosexual transmission is the most frequent mode of HIV transmission, and increased expression of the HIV co-receptor CCR5 is likely to cause enhanced susceptibility to HIV. This study set out to explore CCR5 on CD4+ T-cells in treated and untreated women with FGS.
Methods & Materials: Participants were recruited from a large school based study in KwaZulu-Natal, South Africa. Blood and endocervical cytobrush samples were collected from 19 young women with genital sandy patches detected by colposcopy. The negative controls consisted of 25 patients without genital lesions and with no S. haematobium ova found by urine microscopy. From the FGS positive group, 14 women were seen again 8 months after antischistosomal treatment. Flow cytometry analysis was run with an activation panel including the parameters CD3, CD4 and CCR5. The Mann-Whitney U non-parametric test and the Wilcoxon signed rank test were used when comparing the groups.
Results: The expression of the co-receptor CCR5 on CD4+ cells was higher in blood samples from FGS positives than FGS negatives (4.7% vs. 1.5%, p = 0.018). No significant difference was found in the genital samples (p = 0.29). After anti-schistosomal treatment, the CCR5 expression decreased in both blood and genital samples (p = 0.036 and 0.025, respectively).
Conclusion: The results support the assumption that FGS may increase the risk of HIV acquisition, not only through damage of the mucosal epithelial barrier, but also by altering the co-receptor expression on HIV target cell populations. Anti-schistosomal treatment may modify this effect.
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Citation: Kleppa E, Ramsuran V, Zulu S, Karlsen GH, Bere A, Passmore JA, Ndhlovu P, Lillebo K, Holmen SD, Onsrud M, Gundersen SG, Taylor M, Kjetland EF, Ndung'u T. Expression of the CCR5 HIV co-receptor in women with genital schistosomiasis 16th ICID Abstracts / International Journal of Inf,21S:1-460 (2014).