Schistosomiasis is an acute and chronic
parasitic disease caused by blood flukes of the genus Schistosoma. More than 220 million people worldwide were estimated to have active
schistosomiasis in 2017, 90% of whom live on the African continent, but only 102 million were reported to have received treatment. Africa is also disproportionately burdened by HIV, with an estimated 26 million people living with HIV in 2017. Given these overlapping epidemics, we conducted a systematic review to ascertain the contribution of schistosomes to HIV acquisition risk, the contribution of HIV to schistosome acquisition, the impact of HIV on
schistosomiasis-related morbidity, the impact of schistosomes on HIV
disease progression and immune response, the impact of HIV on the efficacy of
praziquantel treatment, and the impact of HIV on egg shedding. We reviewed studies of people living in sub-Saharan Africa coinfected with HIV and Schistosoma spp. between January 1996 and July 2018. We found that 1)
infection with Schistosoma haematobium increases the risk of HIV acquisition, 2) there is currently a lack of data on whether
HIV infection increases the risk of Schistosoma acquisition, 3a)
HIV coinfection was not an accelerating factor for adverse Schistosoma outcomes, 3b)
schistosomiasis may be an important contributor to immune activation in HIV coinfected people, 4)
praziquantel use in coinfected people may improve immune reconstitution on antiretroviral
therapy for HIV, and 5) there is evidence that
HIV infection reduces egg excretion in individuals infected with Schistosoma mansoni.