Journal
PLOS NEGLECTED TROPICAL DISEASES
Volume 12, Issue 12, Pages -Publisher
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pntd.0006902
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Funding
- Bill and Melinda Gates Foundation [1005342]
- National Institute of Child Health and Development [NICHD R01 HD40125]
- National Institute of Mental Health [NIMH R01 66767]
- AIDS International Training and Research Program Fogarty International Center [D43 TW001042]
- Emory Center for AIDS Research [P30 AI050409]
- National Institute of Allergy and Infectious Diseases [NIAID R01 AI51231, NIAID R01 AI040951, NIAID R01 AI023980, NIAID R01 AI64060, NIAID R37 AI51231]
- US Centers for Disease Control and Prevention [5U2GPS000758]
- International AIDS Vaccine Initiative
- United States Agency for International Development (USAID)
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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<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.
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