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Author Notes:

kmwall@emory.edu

Conceptualization: Yeuk-Mui Lee, Shabir Lakhi, Elwyn Chomba, Erin Shutes, Amanda Tichacek, W. Evan Secor, Susan Allen.

Data curation: Kristin M. Wall, Cecile Dinh, Paul Livingston, Debi Boeras, Htee Khu Naw, Ilene Brill, Rachel Parker.

Formal analysis: Kristin M. Wall, Cecile Dinh, Paul Livingston, Htee Khu Naw, Ilene Brill.

Funding acquisition: Susan Allen.

Investigation: William Kilembe, Bellington Vwalika, Cecile Dinh, Paul Livingston, Yeuk-Mui Lee, Elwyn Chomba, Tyronza Sharkey, Amanda Tichacek, W. Evan Secor, Susan Allen.

Methodology: Kristin M. Wall, William Kilembe, Bellington Vwalika, Yeuk-Mui Lee, Shabir Lakhi, Debi Boeras, Elwyn Chomba, Tyronza Sharkey, Erin Shutes, Amanda Tichacek, W. Evan Secor, Susan Allen.

Project administration: William Kilembe, Bellington Vwalika, Paul Livingston, Yeuk-Mui Lee, Shabir Lakhi, Debi Boeras, Tyronza Sharkey, W. Evan Secor, Susan Allen.

Resources: Yeuk-Mui Lee, Erin Shutes, W. Evan Secor.

Supervision: William Kilembe, Bellington Vwalika, Yeuk-Mui Lee, Tyronza Sharkey, Rachel Parker, Amanda Tichacek, W. Evan Secor, Susan Allen.

Validation: Rachel Parker.

Writing – original draft: Kristin M. Wall.

Writing – review & editing: William Kilembe, Bellington Vwalika, Cecile Dinh, Paul Livingston, Yeuk-Mui Lee, Shabir Lakhi, Debi Boeras, Htee Khu Naw, Ilene Brill, Elwyn Chomba, Tyronza Sharkey, Rachel Parker, Erin Shutes, Amanda Tichacek, W. Evan Secor, Susan Allen.

The authors have declared that no competing interests exist.

Subjects:

Research Funding:

This work was supported by the Bill and Melinda Gates Foundation [Grant ID 1005342], the National Institute of Child Health and Development [NICHD R01 HD40125]; National Institute of Mental Health [NIMH R01 66767]; the AIDS International Training and Research Program Fogarty International Center [D43 TW001042]; the 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]; the US Centers for Disease Control and Prevention [5U2GPS000758]; and the International AIDS Vaccine Initiative.

This study was made possible by the generous support of the American people through the United States Agency for International Development (USAID).

The contents do not necessarily reflect the views of USAID, CDC, or the United States Government.

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Infectious Diseases
  • Parasitology
  • Tropical Medicine
  • FEMALE GENITAL SCHISTOSOMIASIS
  • IMMUNODEFICIENCY-VIRUS TYPE-1
  • DISCORDANT COUPLES
  • RURAL ZIMBABWE
  • HAEMATOBIUM
  • INFECTION
  • LUSAKA
  • RISK
  • PREVALENCE
  • MANSONI

Schistosomiasis is associated with incident HIV transmission and death in Zambia

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Journal Title:

PLoS Neglected Tropical Diseases

Volume:

Volume 12, Number 12

Publisher:

, Pages e0006902-e0006902

Type of Work:

Article | Final Publisher PDF

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<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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This is an Open Access work distributed under the terms of the Creative Commons Universal : Public Domain Dedication License (http://creativecommons.org/publicdomain/zero/1.0/).

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