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
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SCHISTOSOMIASIS ,HIV infection transmission ,SCHISTOSOMIASIS prevention ,ENZYME-linked immunosorbent assay ,ANTIBODY formation ,SCHISTOSOMIASIS treatment - 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 1994โ2012 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<0.005 and aHR = 1.4, p<0.05, respectively) and death in HIV+ women (aHR = 2.2, p<0.001). In 250 HIV- women, presence of S. haematobium-specific antibodies was associated with increased risk of HIV acquisition (aHR = 1.4, p<0.05). Conclusion: Schistosome infections were associated with increased transmission of HIV from both sexes, acquisition of HIV in women, and increased progression to death in HIV+ women. Establishing effective prevention and treatment strategies for schistosomiasis, including in urban adults, may reduce HIV incidence and death in HIV+ persons living in endemic areas. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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