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
UVRI-IAVI HIV Vaccine Program, Entebbe, Uganda.
MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
Trop Med Int Health. 2015 Sep;20(9):1190-1195. doi: 10.1111/tmi.12531. Epub 2015 May 27.
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.
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.
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.
These results do not support the hypothesis that S. mansoni infection promotes HIV acquisition.
有研究表明，在非洲渔业社区流行的曼氏血吸虫可能会增加人类感染免疫缺陷病毒（HIV）的易感性。如果这一结论得到证实，那么在这些HIV高风险社区将具有重大的公共卫生意义。本研究旨在确定曼氏血吸虫感染是否是乌干达维多利亚湖渔业社区HIV感染的危险因素。我们在一个前瞻性HIV发病率队列中进行了一项匹配病例对照研究，在2009年至2011年期间纳入了50例HIV血清转化者（病例）和150例对照。
通过检测储存血清中的循环阳极抗原（CAA）来确定HIV血清转化前的曼氏血吸虫感染情况。使用Determine快速检测法进行HIV检测，并通过酶联免疫吸附试验确认感染。
在HIV血清转化前（或对于对照组，在类似研究访视时），约49%的病例和52%的对照感染了曼氏血吸虫：在对种族、宗教、婚姻状况、教育程度、职业、前3个月饮酒频率、醉酒时性伴侣数量、在社区居住时间以及过去2年的血吸虫病治疗史进行调整后，优势比为1.23（95%CI 0.3 - 5.7），P = 0.79。曼氏血吸虫感染为慢性感染（从入组到HIV血清转化期间感染状态变化不大），病例组和对照组的CAA浓度中位数无差异。
这些结果不支持曼氏血吸虫感染促进HIV感染的假说。
