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

• Published in: Tropical medicine & international health 2015-09, Vol.20 (9), p.1190-1195
• Main Authors: Ssetaala, Ali, Nakiyingi‐Miiro, Jessica, Asiki, Gershim, Kyakuwa, Nassim, Mpendo, Juliet, Van Dam, Govert J., Corstjens, Paul L., Pala, Pietro, Nielsen, Leslie, Bont, Jan De, Pantaleo, Giuseppe, Kiwanuka, Noah, Kaleebu, Pontiano, Kamali, Anatoli, Elliott, Alison M.
• Format: Article
• Language: English
• Subjects: Antigens; antigène anodique circulant; antígeno anódico circulante; circulating anodic antigen; communautés de pêcheurs; comunidades de pescadores; Disease transmission; fishing communities; HIV; Human immunodeficiency virus; Original; Original Research Papers; Ouganda; Parasitic diseases; Risk factors; Schistosoma mansoni; sensibilité; susceptibilidad; susceptibility; Uganda; VIH
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.12531

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. Objectif Il a été suggéré que Schistosoma mansoni, endémique dans les communautés de pêcheurs africains, pourrait augmenter la susceptibilité à l'acquisition du virus de l'immunodéficience humaine (VIH). La confirmation de cette hypothèse serait d'une grande importance pour la santé publique dans ces communautés à risque élevé pour le VIH. Cette étude a été entreprise pour déterminer si l'infection à S. mansoni est un facteur de risque pour l'infection VIH dans les communautés de pêcheurs du lac Victoria, en Ouganda. Nous avons mené une étude cas‐témoins appariés, imbriquée au sein d'une cohorte prospective d'incidence du VIH, comprenant 50 séroconversions VIH (cas) et 150 témoins, durant la période 2009‐2011. Méthodes L'infection à S. mansoni avant la séroconversion VIH a été déterminée par la mesure de l'antigène anodique circulant (AAC) dan