World Journal
of Microbiology
and Biotechnology
7, 433435
Short Communication
Filariasis and malaria sera from Orissa (India) lack human immunodeficiency virus (HIV) antibody reactivity
V.R.
Reports exist indicating a correlation between seroposltlvlty for human T-lymphotrophlc virus (HTLV) antlbodles and certain parasltlc infectlons in some parts of the world. In 274 fllarlasls and 119 malaria sera examlned from Orissa, none was reactive In a test for antibodies to human lmmunodeficlency virus (HIV). The author is with the AIDS Surveillance Unit, Regional Medical Research Centre (Indian Council of Medical Research), Bhubaneswar 751 016, India.
Subramanyam
An intriguing association has been reported between seropositivity for human T-lymphotrophic virus (HTLV) antibodies and certain parasitic infections such as falciparum malaria in Ghana and Zaire (Kestens et al. 1985), filariasis in the Gato islands (Tajima et al. 1983), Chagas disease in Venezuela (Merino et al. 1984) and strongyloidiasis in Okinawa (Nakada et al. 1984). However, no such correlation was observed between malaria and seropositivity for anti-HIV antibodies in American and European populations (Biggar et al. 1985). In India, sero surveillance started in October 1985 and the overall seropositivity rate for HIV antibodies has been low, at 3.8 per 1000. Most of the sera tested are from the urban population (Anon. 1989), where parasitic infections are not highly prevalent. Orissa, a coastal state in eastern India, is highly endemic for filariasis and malaria. There is no published report from India regarding any possible association between parasitic infections and HIV antibody reactivity. The present communication is the first report of such a study.
Materials
@ 7997 Rapid Communications
of Oxford
Ltd.
and Methods
Blood samples were collected from areas of Orissa endemic for Bancroftian filariasis (Puri District) or for falciparum malaria (Keonjhar District). The samples were collected during the period 198588. Filariasis sera were from 191 males and 83 females aged 9 to 86 years (mean age 32 years); malaria sera were from 95 males and 24 females, aged 2 to 65 years (mean age 25 years). HIV antibodies were assayed in all the sera using Wellcozyme anti-HTLV-III ELISA kit (Wellcome Diagnostics, J.K) supplied by the Indian Council of Medical Research, New Delhi. Appropriate control sera (positive, negative and cut-off) were always included and the results were interpreted as per the manufacturer’s instructions. Of the 274 filariasis sera, only 118 were tested for antibodies against Wuchereria bancroft microfilariae somatic antigen by indirect haemagglutination test (Das et al. 1987). All the malaria sera were tested by enzyme-linked immuno-sorbent assay (ELISA), using solubilized Plasmodium falciparum schizont-infected erythrocytes (maintained in vitro) as antigen (Demedts et a/. 1987).
World Journal
of Microbiology
and Biotechnology,
Vol 7, 7991
433
V. FL Subramanyam Table
1. Antibody
titres
in the sera
analysed Titre
against
Category
No.
Filariasis (Bancroftian) Endemic normal Asymptomatic mf carrier Acute Chronic
48 28 9 33
73.8 57.0 64.0 91.6
NT NT NT NT
61
NT NT NT
0.27 k 0.19 0.43 * 0.35 0.48 f 0.09
Malaria Endemic normal P. falciparum P. Wax *Geometric mean t Arithmetic mean NT-not tested.
Results
Microfilariae*
of antibody
54 4
P. falciparumt
of positive values. of A,, values fS.D
and Discussion
The sera tested had high titres of antibody against the homologous parasite antigen, as expected in endemic areas (Table 1). However, all the sera were negative for HIV antibodies. Thus, the situation in Orissa appears to be different from that prevailing in populations of Africa where a strong correlation was observed between antibodies against P. falciparum and HIV antibody reactivity (Facer et al. 1986), or the Gato islands of Japan where HTLV-I antibody reactivity was associated with filariasis (Tajima et al. 1983). In sero-epidemiological investigations of HIV infection, it is equally important to gather data on the prevalence of antibodies to HIV in the absence of evidence for infection with HIV because of the far-reaching implications that a false diagnosis can have. Though possible explanations have been offered for the correlation between high malaria and filaria antibody titres and retrovirus antibody reactivity in certain geographic areas and the lack of such correlation in certain other areas (Biggar et al. 1985), further epidemiological studies are warranted, with particular emphasis on the incidence of HIV vis-ri-vis the parasitic infection in different parts of the world, for validating the offered explanations.
Acknowledgements The author thanks Mr P.K. for helpful discussions.
Sahoo for technical
assistance and Dr B. Ravindran
References ANON. 1989 HIV infection--ongoing studies and future research plans. Bulletin, Indian Council of Medical Research 19, 1 1 %129. BIGGAR, R.J., GIGASE, P.L., MELBYE, M., KESTENS, L., SARIN, P.S., BODNER, A.J., DEMEDTS, P., STEVENS, W. J., PALUKU, L., DELACOLLETTE, C. & BLATTNER, W.A. 1985 ELISA HTLV retrovirus antibody reactivity associated with malaria and immune complex in healthy Africans. Lancet 2, 52G523. DAS, M.K., SUBRAMANYAM, v.R., RAVINDRAN, B. & PATTNAIK, N.M. 1987 A study of the antigen, antibody and immune complex levels in Wuchereria bancroft filariasis with reference to clinical status. Jozmal of Tropical Medicine and Hygiene 90, 135-141. DEMEDTS, P., OVERMEIR, C.V. & WERY, M. 1987 Simultaneous use of Plasmodium j&~urum crude antigen and red blood cell control antigen in the enzyme-linked immunosorbent assay for malaria. American Journal of Tropical Medicine and Hygiene 36, 257-263.
434
World
Journal
of Microbiology
and Biotechnology,
Vol 7, 7991
HI If antibody in parasitic
diseases
FACER,C.A., BENTLEY,A., WITHERS, M. & KATAAHA, P.K. 1986 Malaria and ELISA HTLV-III Hygiene
antibody
reactivity.
Transactions of the Royaal Societ_y of Tropical
Medicine
and
80, 351-352.
KESTENS, L., BIGGAR, R.J., MELBYE, M., BODNER, A.J., DE FEYTER, A.J. & GIGASE, P.L. 1985 Absence of immunosuppression in healthy subjects from eastern Zaire who are positive for HTLV-III antibodies. Ne2v England Journal of Medicine 312, 1517-1518. MERINO, F., ROBERT-GUROFF, M., CLARK, J., BLATTNER, W.A. & GALLO, R.C. 1984 Natural antibodies to human T-cell leukemia/lymphoma virus in healthy Venezuelan populations. International Journal of Cancer 34, 501-506. NAKADA, K., KOHAKURA, M., KOMODA, H. & HINUMA, Y. 1984 High incidence of HTLV antibody in carriers of Strongyioides stercorah. Lancet 1, 633. TAJIMA, K., FUJITA, K., TSUKIDATE, S., ODA, T., TOMINAGA, S., SLJCHI,T. & HINUMA, Y. 1983 Seroepidemiological studies on the effects of filarial parasites on infestation of adult T-cell leukemia virus in the Gato Islands, Japan. Gann 74, 191.
(Received 13 September 1990; revised 28 November
World
Journal
of Microbiology
1990; accepted I December 1990)
and Biotechnology,
Vol 7, 1991
435
of Microbiology
and Biotechnology
7, 433435
Short Communication
Filariasis and malaria sera from Orissa (India) lack human immunodeficiency virus (HIV) antibody reactivity
V.R.
Reports exist indicating a correlation between seroposltlvlty for human T-lymphotrophlc virus (HTLV) antlbodles and certain parasltlc infectlons in some parts of the world. In 274 fllarlasls and 119 malaria sera examlned from Orissa, none was reactive In a test for antibodies to human lmmunodeficlency virus (HIV). The author is with the AIDS Surveillance Unit, Regional Medical Research Centre (Indian Council of Medical Research), Bhubaneswar 751 016, India.
Subramanyam
An intriguing association has been reported between seropositivity for human T-lymphotrophic virus (HTLV) antibodies and certain parasitic infections such as falciparum malaria in Ghana and Zaire (Kestens et al. 1985), filariasis in the Gato islands (Tajima et al. 1983), Chagas disease in Venezuela (Merino et al. 1984) and strongyloidiasis in Okinawa (Nakada et al. 1984). However, no such correlation was observed between malaria and seropositivity for anti-HIV antibodies in American and European populations (Biggar et al. 1985). In India, sero surveillance started in October 1985 and the overall seropositivity rate for HIV antibodies has been low, at 3.8 per 1000. Most of the sera tested are from the urban population (Anon. 1989), where parasitic infections are not highly prevalent. Orissa, a coastal state in eastern India, is highly endemic for filariasis and malaria. There is no published report from India regarding any possible association between parasitic infections and HIV antibody reactivity. The present communication is the first report of such a study.
Materials
@ 7997 Rapid Communications
of Oxford
Ltd.
and Methods
Blood samples were collected from areas of Orissa endemic for Bancroftian filariasis (Puri District) or for falciparum malaria (Keonjhar District). The samples were collected during the period 198588. Filariasis sera were from 191 males and 83 females aged 9 to 86 years (mean age 32 years); malaria sera were from 95 males and 24 females, aged 2 to 65 years (mean age 25 years). HIV antibodies were assayed in all the sera using Wellcozyme anti-HTLV-III ELISA kit (Wellcome Diagnostics, J.K) supplied by the Indian Council of Medical Research, New Delhi. Appropriate control sera (positive, negative and cut-off) were always included and the results were interpreted as per the manufacturer’s instructions. Of the 274 filariasis sera, only 118 were tested for antibodies against Wuchereria bancroft microfilariae somatic antigen by indirect haemagglutination test (Das et al. 1987). All the malaria sera were tested by enzyme-linked immuno-sorbent assay (ELISA), using solubilized Plasmodium falciparum schizont-infected erythrocytes (maintained in vitro) as antigen (Demedts et a/. 1987).
World Journal
of Microbiology
and Biotechnology,
Vol 7, 7991
433
V. FL Subramanyam Table
1. Antibody
titres
in the sera
analysed Titre
against
Category
No.
Filariasis (Bancroftian) Endemic normal Asymptomatic mf carrier Acute Chronic
48 28 9 33
73.8 57.0 64.0 91.6
NT NT NT NT
61
NT NT NT
0.27 k 0.19 0.43 * 0.35 0.48 f 0.09
Malaria Endemic normal P. falciparum P. Wax *Geometric mean t Arithmetic mean NT-not tested.
Results
Microfilariae*
of antibody
54 4
P. falciparumt
of positive values. of A,, values fS.D
and Discussion
The sera tested had high titres of antibody against the homologous parasite antigen, as expected in endemic areas (Table 1). However, all the sera were negative for HIV antibodies. Thus, the situation in Orissa appears to be different from that prevailing in populations of Africa where a strong correlation was observed between antibodies against P. falciparum and HIV antibody reactivity (Facer et al. 1986), or the Gato islands of Japan where HTLV-I antibody reactivity was associated with filariasis (Tajima et al. 1983). In sero-epidemiological investigations of HIV infection, it is equally important to gather data on the prevalence of antibodies to HIV in the absence of evidence for infection with HIV because of the far-reaching implications that a false diagnosis can have. Though possible explanations have been offered for the correlation between high malaria and filaria antibody titres and retrovirus antibody reactivity in certain geographic areas and the lack of such correlation in certain other areas (Biggar et al. 1985), further epidemiological studies are warranted, with particular emphasis on the incidence of HIV vis-ri-vis the parasitic infection in different parts of the world, for validating the offered explanations.
Acknowledgements The author thanks Mr P.K. for helpful discussions.
Sahoo for technical
assistance and Dr B. Ravindran
References ANON. 1989 HIV infection--ongoing studies and future research plans. Bulletin, Indian Council of Medical Research 19, 1 1 %129. BIGGAR, R.J., GIGASE, P.L., MELBYE, M., KESTENS, L., SARIN, P.S., BODNER, A.J., DEMEDTS, P., STEVENS, W. J., PALUKU, L., DELACOLLETTE, C. & BLATTNER, W.A. 1985 ELISA HTLV retrovirus antibody reactivity associated with malaria and immune complex in healthy Africans. Lancet 2, 52G523. DAS, M.K., SUBRAMANYAM, v.R., RAVINDRAN, B. & PATTNAIK, N.M. 1987 A study of the antigen, antibody and immune complex levels in Wuchereria bancroft filariasis with reference to clinical status. Jozmal of Tropical Medicine and Hygiene 90, 135-141. DEMEDTS, P., OVERMEIR, C.V. & WERY, M. 1987 Simultaneous use of Plasmodium j&~urum crude antigen and red blood cell control antigen in the enzyme-linked immunosorbent assay for malaria. American Journal of Tropical Medicine and Hygiene 36, 257-263.
434
World
Journal
of Microbiology
and Biotechnology,
Vol 7, 7991
HI If antibody in parasitic
diseases
FACER,C.A., BENTLEY,A., WITHERS, M. & KATAAHA, P.K. 1986 Malaria and ELISA HTLV-III Hygiene
antibody
reactivity.
Transactions of the Royaal Societ_y of Tropical
Medicine
and
80, 351-352.
KESTENS, L., BIGGAR, R.J., MELBYE, M., BODNER, A.J., DE FEYTER, A.J. & GIGASE, P.L. 1985 Absence of immunosuppression in healthy subjects from eastern Zaire who are positive for HTLV-III antibodies. Ne2v England Journal of Medicine 312, 1517-1518. MERINO, F., ROBERT-GUROFF, M., CLARK, J., BLATTNER, W.A. & GALLO, R.C. 1984 Natural antibodies to human T-cell leukemia/lymphoma virus in healthy Venezuelan populations. International Journal of Cancer 34, 501-506. NAKADA, K., KOHAKURA, M., KOMODA, H. & HINUMA, Y. 1984 High incidence of HTLV antibody in carriers of Strongyioides stercorah. Lancet 1, 633. TAJIMA, K., FUJITA, K., TSUKIDATE, S., ODA, T., TOMINAGA, S., SLJCHI,T. & HINUMA, Y. 1983 Seroepidemiological studies on the effects of filarial parasites on infestation of adult T-cell leukemia virus in the Gato Islands, Japan. Gann 74, 191.
(Received 13 September 1990; revised 28 November
World
Journal
of Microbiology
1990; accepted I December 1990)
and Biotechnology,
Vol 7, 1991
435
