Impact of HIV and Schistosoma co-exposure on pulmonary vascular pathophysiology

Abstract

HIV and Schistosoma infections have been individually associated with pulmonary vascular disease. Co-infection with these pathogens is very common in tropical areas, with an estimate of more than six million people co-infected only in Africa. However, the effects of HIV and Schistosoma co-exposure on the pulmonary vasculature and its impact on the development of pulmonary vascular disease are largely unknown, due partly to the scarcity of experimental models. Since HIV proteins and Schistosoma eggs are the primary triggers of vascular pathology, it could be hypothesized that co-exposure to HIV and Schistosoma would allow for severe and rapidly pulmonary vascular disease progression, such as pulmonary arterial hypertension (PAH).HIV-associated PAH is characterized by proliferative vasculopathy with intimal fibrosis and development of plexiform lesions. is vascular damage is associated with a narrowing of the pulmonary vessel lumen, which over time, increases pulmonary pressure. e mechanisms involved in HIV-associated PAH are not yet well understood. Still, viral proteins have been postulated to play a role in the endothelial dysfunction observed. On the other hand, schistosomiasis-associated lung pathology is thought to be triggered by embolization of schistosome eggs into the lungs, leading to in ammation and pulmonary vascular remodelling. us, peri-egg granulomas formation and vascular remodelling with perivascular in ltrates and vessel wall thickening are considered critical events in the schistosomiasis-associated pulmonary pathology...