Maganga Jane K, Pham Khanh, Changalucha John M, Downs Jennifer A
Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.
Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
Lancet HIV. 2025 Jan;12(1):e60-e70. doi: 10.1016/S2352-3018(24)00234-0. Epub 2024 Oct 25.
The sex of people living with HIV-1 infection, schistosome infection, or both, is a fundamental determinant of their clinical outcomes and of how these two infections interact in the host. Data from longitudinal and cross-sectional human studies and animal models indicate that males with HIV-1 and schistosome co-infection excrete fewer schistosome eggs and might have higher HIV-1 RNA viral loads and greater liver damage. Females with schistosome infection appear to have higher risk of HIV-1 acquisition than females without, particularly in Schistosoma haematobium infection, and a greater risk of death in HIV-1 and schistosome co-infection. Greater transmission of HIV-1 to partners has been shown in both sexes in those with schistosome infection. Biological sex is a consequential factor affecting pathophysiological and clinical responses in HIV-1 and schistosome co-infection. Designing future analyses to incorporate sex is vital to optimise research and care for people living with HIV-1, schistosomes, and HIV-1 and schistosome co-infection.
感染HIV-1、血吸虫，或同时感染这两种病原体的人群的性别，是其临床结局以及这两种感染在宿主体内如何相互作用的一个基本决定因素。纵向和横断面人体研究以及动物模型的数据表明，同时感染HIV-1和血吸虫的男性排出的血吸虫卵较少，并且可能具有更高的HIV-1 RNA病毒载量和更严重的肝损伤。感染血吸虫的女性感染HIV-1的风险似乎高于未感染的女性，尤其是在感染埃及血吸虫的情况下，并且在同时感染HIV-1和血吸虫时死亡风险更高。在感染血吸虫的人群中，已表明男女将HIV-1传播给性伴侣的几率都更高。生理性别是影响HIV-1和血吸虫合并感染时病理生理和临床反应的一个重要因素。设计纳入性别的未来分析对于优化针对感染HIV-1、血吸虫以及同时感染HIV-1和血吸虫的人群的研究与照护至关重要。
