1. Schistosomiasis is associated with incident HIV transmission and death in Zambia
- Author
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Wall, Kristin M., Kilembe, William, Vwalika, Bellington, Dinh, Cecile, Livingston, Paul, Lee, Yeuk-Mui, Lakhi, Shabir, Boeras, Debi, Naw, Htee Khu, Brill, Ilene, Chomba, Elwyn, Sharkey, Tyronza, Parker, Rachel, Shutes, Erin, Tichacek, Amanda, Secor, W. Evan, and Allen, Susan
- Subjects
RNA viruses ,Male ,Schistosoma Mansoni ,Physiology ,RC955-962 ,HIV Infections ,Pathology and Laboratory Medicine ,Biochemistry ,Cohort Studies ,Schistosomiasis haematobia ,Immunodeficiency Viruses ,Immune Physiology ,Arctic medicine. Tropical medicine ,Medicine and Health Sciences ,Schistosomiasis ,Enzyme-Linked Immunoassays ,Immune System Proteins ,Incidence ,Eukaryota ,virus diseases ,Viral Load ,Medical Microbiology ,Helminth Infections ,Viral Pathogens ,Viruses ,Schistosoma haematobium ,Schistosoma ,Female ,Pathogens ,Public aspects of medicine ,RA1-1270 ,Research Article ,Neglected Tropical Diseases ,Adult ,Immunology ,Zambia ,Research and Analysis Methods ,Microbiology ,Antibodies ,Young Adult ,Helminths ,Virology ,Retroviruses ,Parasitic Diseases ,Animals ,Humans ,Immunoassays ,Microbial Pathogens ,Retrospective Studies ,Lentivirus ,Organisms ,Biology and Life Sciences ,HIV ,Proteins ,Tropical Diseases ,Invertebrates ,Schistosomiasis mansoni ,Case-Control Studies ,Immunologic Techniques ,Viral Transmission and Infection - Abstract
Background We examined relationships between schistosome infection, HIV transmission or acquisition, and all-cause death. Methods We retrospectively tested baseline sera from a heterosexual HIV-discordant couple cohort in Lusaka, Zambia with follow-up from 1994–2012 in a nested case-control design. Schistosome-specific antibody levels were measured by ELISA. Associations between baseline antibody response to schistosome antigens and incident HIV transmission, acquisition, and all-cause death stratified by gender and HIV status were assessed. In a subset of HIV- women and HIV+ men, we performed immunoblots to evaluate associations between Schistosoma haematobium or Schistosoma mansoni infection history and HIV incidence. Results Of 2,145 individuals, 59% had positive baseline schistosome-specific antibody responses. In HIV+ women and men, baseline schistosome-specific antibodies were associated with HIV transmission to partners (adjusted hazard ratio [aHR] = 1.8, p, Author summary This study explored the association between schistosome infections (a disease caused by parasitic flatworms, also known as ‘snail fever’, which is very common throughout sub-Saharan Africa) and human immunodeficiency virus (HIV). We found in Lusaka, the capital of Zambia, that schistosome infections were associated with transmission of HIV from adult men and women, and schistosome infections were also associated with increased HIV acquisition in adult women. We additionally found that schistosome infections were associated with death in HIV+ adult women. Since treatment of schistosome infections with praziquantel is inexpensive, effective, and safe, schistosomiasis prevention and treatment strategies may be a cost-effective way to reduce not only the symptoms associated with the infection, but also new cases of HIV and death among HIV+ persons. Though often viewed as an infection of predominantly rural areas and children, this study highlights that schistosomiasis prevention and treatment efforts are also needed in urban areas and among adults.
- Published
- 2018