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Childhood HIV schistosomiasis coinfection requires more research
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Further research on HIV and schistosomiasis coinfection among children in sub-Saharan Africa is needed to prevent additional infections among the children most at risk, according to study findings in The Lancet Infectious Diseases.
Schistosomiasis, a chronic inflammatory disease caused by a waterborne parasitic blood fluke, infects 220 million people in sub-Saharan Africa, many of them children, according to background information in the study. Although congenital transmission does not occur, exposure and infection can take place soon after birth, depending on an infant’s exposure to parasite-infested water. There is a serious geographical overlap between schistosomiasis and HIV in poor countries, where endemicity can be high.
Amaya Bustinduy, MD, of the Liverpool School of Tropical Medicine, and colleagues reviewed research on HIV and schistosomiasis coinfection, and they found most of clinical studies involved patients aged at least 18 years. As a result, researchers developed a new research agenda that focuses on coinfection among children.
The agenda calls for:
- Better documentation of the relation between HIV and concurrent helminthiasis in mothers and unborn children, including efforts to develop noninvasive imagery methods or assays for identifying female genital schistosomiasis;
- Administration of praziquantel (Biltricide, Bayer HealthCare) to pregnant women with genital schistosomiasis;
- Recorded rates of HIV transmission from treated mothers to children;
- Further research of coinfected children’s response to immunization, particularly children born to women with schistosomiasis;
- Field investigation of the efficacy of praziquantel among children; and
- Further investigation of the interaction between antiparasitic drugs used in preventive chemotherapy, antiretroviral therapy and tuberculosis treatments.
“Failure to develop and implement a realistic research agenda for infected children will result in the neglect of the youngest children who might be at particular risk for increased HIV transmission, HIV progression, and impaired response to drugs,” study researcher Russell Stothard, PhD, of the Liverpool School of Tropical Medicine, said in a press release.
Disclosure: The researchers report no relevant financial disclosures.
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