Association of Schistosomiasis and HIV Infection in Tanzania
Association of Schistosomiasis and HIV Infection in Tanzania
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DOI：
10.4269/ajtmh.2012.12-0395
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发表时间：
2012-11-01
影响因子：
3.3
通讯作者：
Fitzgerald, Daniel W.
中科院分区：
文献类型：
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作者：
Downs, Jennifer A.;van Dam, Govert J.;Fitzgerald, Daniel W.
动物和人类研究表明，曼氏血吸虫感染可能会增加感染人类免疫缺陷病毒 (HIV) 的风险。因此，我们通过循环阳极抗原 (CAA) 血清检测，对维多利亚湖附近的坦桑尼亚乡村（曼氏沙门氏菌高流行）的 345 名育龄妇女进行了性传播感染 (STI) 和血吸虫病检测。超过二分之一（54%）患有活动性血吸虫感染； 6% 的 HIV 血清呈阳性。通过单变量分析，只有血吸虫感染可以预测 HIV 感染（比值比 [OR] = 3.9，95% 置信区间 = [1.3-12.0]，P = 0.015），并且使用多变量分析控制年龄、性传播感染和距湖泊的距离仍然显着（OR = 6.2 [1.7-22.9]，P = 0.006）。在血吸虫感染较严重的女性中，HIV 患病率较高 (P = 0.005)，且感染 HIV 的女性的中位血吸虫强度高于未感染的女性 (400 与 15 pg CAA/mL，P = 0.01)。这一发现表明，曼氏沙门氏菌感染可能是一种可改变的艾滋病毒风险因素，使全世界数百万人感染艾滋病毒的风险增加。
Animal and human studies suggest that Schistosoma mansoni infection may increase risk of human immunodeficiency virus (HIV) acquisition. Therefore, we tested 345 reproductive age women in rural Tanzanian villages near Lake Victoria, where S. mansoni is hyperendemic, for sexually transmitted infections (STIs) and schistosomiasis by circulating anodic antigen (CAA) serum assay. Over one-half (54%) had an active schistosome infection; 6% were HIV-seropositive. By univariate analysis, only schistosome infection predicted HIV infection (odds ratio [OR] = 3.9, 95% confidence interval = [1.3-12.0], P = 0.015) and remained significant using multivariate analysis to control for age, STIs, and distance from the lake (OR = 6.2 [1.7-22.9], P = 0.006). HIV prevalence was higher among women with more intense schistosome infections (P = 0.005), and the median schistosome intensity was higher in HIV-infected than -uninfected women (400 versus 15 pg CAA/mL, P = 0.01). This finding suggests that S. mansoni infection may be a modifiable HIV risk factor that places millions of people worldwide at increased risk of HIV acquisition.