Immunophenotypic Lymphocyte Profiles in Human African Trypanosomiasis

Human African trypanosomiasis (HAT) is a deadly vector-born disease caused by an extracellular parasite, the trypanosome. Little is known about the cellular immune responses elicited by this parasite in humans. We used multiparameter flow cytometry to characterize leukocyte immunophenotypes in the blood and cerebrospinal fluid (CSF) of 33 HAT patients and 27 healthy controls identified during a screening campaign in Angola and Gabon. We evaluated the subsets and activation markers of B and T lymphocytes. Patients had a higher percentage of CD19(+) B lymphocytes and activated B lymphocytes in the blood than did controls, but lacked activated CD4+ T lymphocytes (CD25(+)). Patients displayed no increase in the percentage of activated CD8+ T cells (HLA-DR(+), CD69(+) or CD25(+)), but memory CD8 T-cell levels (CD8(+)CD45RA(−)) were significantly lower in patients than in controls, as were effector CD8 T-cell levels (CD8(+)CD45RA(+)CD62L(−)). No relationship was found between these blood immunophenotypes and disease severity (stage 1 vs 2). However, CD19(+) B-cell levels in the CSF increased with disease severity. The patterns of T and B cell activation in HAT patients suggest that immunomodulatory mechanisms may operate during infection. Determinations of CD19(+) B-cell levels in the CSF could improve disease staging.