Female Genital Schistosomiasis and HIV-1 Incidence in Zambian Women: A Retrospective Cohort Study.
Female Genital Schistosomiasis and HIV-1 Incidence in Zambian Women: A Retrospective Cohort Study.
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DOI：
10.1093/ofid/ofab349
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发表时间：
2021-07
影响因子：
4.2
通讯作者：
Bustinduy AL
中科院分区：
文献类型：
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作者：
Sturt AS;Webb EL;Phiri CR;Mudenda M;Mapani J;Kosloff B;Cheeba M;Shanaube K;Bwalya J;Kjetland EF;Francis SC;Corstjens PLAM;van Dam GJ;van Lieshout L;Hansingo I;Ayles H;Hayes RJ;Bustinduy AL
女性生殖器血吸虫病（FGS）与HIV-1的流行有关。我们估计了赞比亚妇女的HIV-1感染的发病率与FGS。在2018年1月至8月HPTN 071（PopART）人群队列的最终随访时，邀请女性（年龄18-31岁，未妊娠，性活跃）参加本研究。入组时的HIV-1阴性受试者（n = 492）纳入本分析，并在HPTN 071（PopART）中进行检测以确认HIV-1事件。采用精确Poisson回归分析评估了偶发HIV-1感染与FGS（通过聚合酶链反应[PCR]在任何生殖器标本中检测到的血吸虫DNA）的相关性。在4.1%（20/492）的参与者中观察到HIV-1感染事件。有FGS的女性发生血清转化的可能性是无FGS的女性的两倍，但没有统计学证据表明存在差异（校正率比，2.16; 95%CI，0.21-12.30; P = 0.33）。探索性分析表明，在生殖器PCR标本阳性≥2例的女性中，HIV-1感染与HIV-1感染相关（率比，6.02; 95%CI，0.58-34.96; P = 0.13）。尽管FGS妇女的HIV血清转换率较高，但没有统计学证据表明两者之间存在关联，可能是由于功效较低。进一步的纵向研究应该在血吸虫病高度流行的背景下调查这种联系。
Female genital schistosomiasis (FGS) has been associated with prevalent HIV-1. We estimated the incidence of HIV-1 infection in Zambian women with and without FGS. Women (aged 18–31, nonpregnant, sexually active) were invited to participate in this study in January–August 2018 at the final follow-up of the HPTN 071 (PopART) Population Cohort. HIV-1-negative participants at enrollment (n = 492) were included in this analysis, with testing to confirm incident HIV-1 performed in HPTN 071 (PopART). The association of incident HIV-1 infection with FGS (Schistosoma DNA detected by polymerase chain reaction [PCR] in any genital specimen) was assessed with exact Poisson regression. Incident HIV-1 infections were observed in 4.1% (20/492) of participants. Women with FGS were twice as likely to seroconvert as women without FGS but with no statistical evidence for a difference (adjusted rate ratio, 2.16; 95% CI, 0.21–12.30; P = .33). Exploratory analysis suggested an association with HIV-1 acquisition among women with ≥2 positive genital PCR specimens (rate ratio, 6.02; 95% CI, 0.58–34.96; P = .13). Despite higher HIV seroconversion rates in women with FGS, there was no statistical evidence of association, possibly due to low power. Further longitudinal studies should investigate this association in a setting with higher schistosomiasis endemicity.