Sturt Amy S, Webb Emily L, Phiri Comfort R, Mudenda Maina, Mapani Joyce, Kosloff Barry, Cheeba Maina, Shanaube Kwame, Bwalya Justin, Kjetland Eyrun F, Francis Suzanna C, Corstjens Paul L A M, van Dam Govert J, van Lieshout Lisette, Hansingo Isaiah, Ayles Helen, Hayes Richard J, Bustinduy Amaya L
Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.
MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
Open Forum Infect Dis. 2021 Jun 30;8(7):ofab349. doi: 10.1093/ofid/ofab349. eCollection 2021 Jul.
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 ( 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; = .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; = .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.
女性生殖器血吸虫病（FGS）与HIV-1流行有关。我们估计了患有和未患有FGS的赞比亚女性中HIV-1感染的发病率。
邀请年龄在18 - 31岁、非妊娠、有性行为的女性参加本研究，研究于2018年1月至8月在HPTN 071（PopART）人群队列的最终随访中进行。本分析纳入了入组时HIV-1阴性的参与者（n = 492），在HPTN 071（PopART）中进行检测以确认新发HIV-1感染情况。采用精确泊松回归评估新发HIV-1感染与FGS（在任何生殖器标本中通过聚合酶链反应[PCR]检测到DNA）之间的关联。
4.1%（20/492）的参与者出现了新发HIV-1感染。患有FGS的女性血清转化的可能性是未患有FGS女性的两倍，但无统计学差异证据（调整率比为2.16；95%CI为0.21 - 12.30；P = 0.33）。探索性分析表明，在生殖器PCR标本≥2次呈阳性的女性中，HIV-1感染与之存在关联（率比为6.02；95%CI为0.58 - 34.96；P = 0.13）。
尽管患有FGS的女性HIV血清转化率较高，但无统计学关联证据，可能是由于检验效能不足。进一步的纵向研究应在血吸虫病流行程度较高的环境中调查这种关联。
