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Trop Med Int Health. 2015 Sep;20(9):1190-1195. doi: 10.1111/tmi.12531. Epub 2015 May 27.

Schistosoma mansoni and HIV acquisition in fishing communities of Lake Victoria, Uganda: a nested case-control study.

Author information

1
UVRI-IAVI HIV Vaccine Program, Entebbe, Uganda.
2
MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
3
London School of Hygiene & Tropical Medicine, London, UK.
4
Leiden University Medical Center, Leiden, The Netherlands.
5
International AIDS Vaccine Initiative, New York, NY, USA.
6
Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
7
Makerere College of Health Sciences, School of Public Health, Kampala, Uganda.
8
Uganda Virus Research Institute, Entebbe, Uganda.

Abstract

OBJECTIVE:

It has been suggested that Schistosoma mansoni, which is endemic in African fishing communities, might increase susceptibility to human immunodeficiency virus (HIV) acquisition. If confirmed, this would be of great public health importance in these high HIV-risk communities. This study was undertaken to determine whether S. mansoni infection is a risk factor for HIV infection among the fishing communities of Lake Victoria, Uganda. We conducted a matched case-control study, nested within a prospective HIV incidence cohort, including 50 HIV seroconverters (cases) and 150 controls during 2009-2011.

METHODS:

S. mansoni infection prior to HIV seroconversion was determined by measuring serum circulating anodic antigen (CAA) in stored serum. HIV testing was carried out using the Determine rapid test and infection confirmed by enzyme-linked immunosorbent assays.

RESULTS:

About 49% of cases and 52% of controls had S. mansoni infection prior to HIV seroconversion (or at the time of a similar study visit, for controls): odds ratio, adjusting for ethnicity, religion, marital status, education, occupation, frequency of alcohol consumption in previous 3 months, number of sexual partners while drunk, duration of stay in the community, and history of schistosomiasis treatment in the past 2 years was 1.23 (95% CI 0.3-5.7) P = 0.79. S. mansoni infections were chronic (with little change in status between enrolment and HIV seroconversion), and there was no difference in median CAA concentration between cases and controls.

CONCLUSIONS:

These results do not support the hypothesis that S. mansoni infection promotes HIV acquisition.

KEYWORDS:

Schistosoma mansoni ; VIH ; HIV; Ouganda; Schistosoma mansoni; Uganda; antigène anodique circulant; antígeno anódico circulante; circulating anodic antigen; communautés de pêcheurs; comunidades de pescadores; fishing communities; sensibilité; susceptibilidad; susceptibility

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