Decrease in Seminal HIV-1 RNA Load After Praziquantel Treatment of Urogenital Schistosomiasis Coinfection in HIV-Positive Men—An Observational Study.

Midzi, Nicholas; Mduluza, Takafira; Mudenge, Boniface; Foldager, Leslie; Leutscher, Peter D C

Background Urogenital schistosomiasis due to Schistosoma hematobium infection is hypothesized to cause increased HIV-1 RNA shedding in semen in HIV co-infected men as result of chronic egg-induced inflammation in the prostate and the seminal vesicles. The effect of treatment with the antihelminthic agent praziquantel on seminal HIV-1 RNA load was assessed in this study. Methods HIV-1 RNA load was determined in blood plasma and semen at baseline and at 10-week follow-up. Praziquantel was administered at baseline and two weeks later. Results Eighteen HIV-positive men with S. haematobium co-infection were enrolled into the study. Status of antiretroviral therapy (ART): 6 ART-naïve and 12 ART-experienced. All participants became egg-negative in urine at follow-up. Among the ART-naïve men, the mean HIV-1 RNA load decreased by 0.32 log10 copies per mL (4.41 vs 4.09) in blood plasma from baseline to follow-up, and in semen by 1.06 log10 copies per mL (4.06 vs 3.00). Conclusions This study demonstrated a decline in seminal HIV-1 RNA load following praziquantel treatment of urogenital schistosomiasis infection in HIV-positive men. The finding needs further exploration in a larger randomized study targeting praziquantel as a supplementary preventive measure of sexual transmission of HIV-1 in S. haematobium endemic areas in sub-Saharan Africa.

PREVENTION of sexually transmitted diseases; ISOQUINOLINE; BLOOD testing; MALE reproductive organs; HIV; INFLAMMATION; SCIENTIFIC observation; PROSTATE; SCHISTOSOMIASIS; URINALYSIS; COMORBIDITY; HIGHLY active antiretroviral therapy; TREATMENT effectiveness; SEMEN analysis; THERAPEUTICS

Open Forum Infectious Diseases, 2017, Vol 4, Issue 4, pN.PAG

2328-8957

Academic Journal

10.1093/ofid/ofx199