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Schistosomiasis associated with HIV transmission, death
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Researchers found that schistosome infection was associated with increased transmission of HIV from both men and women in Zambia, as well as HIV acquisition in women and progression to death in HIV-positive women.
Writing in PLoS Neglected Tropical Diseases, Kristin M. Wall, PhD, assistant professor of epidemiology in the Rollins School of Public Health at Emory University, and colleagues noted that treatment for schistosomiasis — an infection caused by parasitic flatworms that is very common through sub-Saharan Africa — has been previously proposed as an intervention against HIV.
“Establishing robust prevention and treatment programs with praziquantel — which is inexpensive, effective and safe — may be a highly effective and cost-effective way to reduce both schistosome morbidity as well as HIV incidence and death,” Wall told Infectious Disease News. “This study highlights that such programs may be needed for adults in urban areas.”
To study the association between schistosomiasis and HIV, Wall and colleagues retrospectively tested baseline sera from heterosexual HIV-discordant couples who were enrolled in an open cohort with longitudinal follow-up every 3 months between 1994 and 2012 in Lusaka, the capital of Zambia. They used ELISA to determine schistosome-specific antibody levels and evaluated a subset of HIV-negative women and HIV-positive men to measure the associations between Schistosoma haematobium or S. mansoni infection and HIV incidence.
They found that 59% of 2,145 people in the study had baseline schistosome-specific antibody responses and that baseline schistosome-specific antibodies in HIV-positive women and men were associated with HIV transmission to partners (adjusted HR = 1.8 for women and aHR = 1.4 for men), as well as death in the HIV-positive women (aHR = 2.2). According to Wall and colleagues, among 250 HIV-negative women, there was an association between the presence of S. haematobium-specific antibodies and an increased risk for acquiring HIV (aHR = 1.4).
“Our findings underscore the importance of schistosomiasis treatment and prevention. Further, we argue for integration of routine parasitological testing and treatment in HIV programs,” they wrote. – by Bruce Thiel
Disclosures: The authors report no relevant financial disclosures.
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