%0 Journal Article
%T Schistosomiasis is associated with incident HIV transmission and death in Zambia
%A Amanda Tichacek
%A Bellington Vwalika
%A Cecile Dinh
%A Debi Boeras
%A Elwyn Chomba
%A Erin Shutes
%A Htee Khu Naw
%A Ilene Brill
%A Kristin M. Wall
%A Paul Livingston
%A Rachel Parker
%A Shabir Lakhi
%A Susan Allen
%A Tyronza Sharkey
%A W. Evan Secor
%A William Kilembe
%A Yeuk-Mui Lee
%J -
%D 2018
%R 10.1371/journal.pntd.0006902
%X Background We examined relationships between schistosome infection, HIV transmission or acquisition, and all-cause death.   Methods We retrospectively tested baseline sera from a heterosexual HIV-discordant couple cohort in Lusaka, Zambia with follow-up from 1994¨C2012 in a nested case-control design. Schistosome-specific antibody levels were measured by ELISA. Associations between baseline antibody response to schistosome antigens and incident HIV transmission, acquisition, and all-cause death stratified by gender and HIV status were assessed. In a subset of HIV- women and HIV+ men, we performed immunoblots to evaluate associations between Schistosoma haematobium or Schistosoma mansoni infection history and HIV incidence.   Results Of 2,145 individuals, 59% had positive baseline schistosome-specific antibody responses. In HIV+ women and men, baseline schistosome-specific antibodies were associated with HIV transmission to partners (adjusted hazard ratio [aHR] = 1.8, p<0.005 and aHR = 1.4, p<0.05, respectively) and death in HIV+ women (aHR = 2.2, p<0.001). In 250 HIV- women, presence of S. haematobium-specific antibodies was associated with increased risk of HIV acquisition (aHR = 1.4, p<0.05).   Conclusion Schistosome infections were associated with increased transmission of HIV from both sexes, acquisition of HIV in women, and increased progression to death in HIV+ women. Establishing effective prevention and treatment strategies for schistosomiasis, including in urban adults, may reduce HIV incidence and death in HIV+ persons living in endemic areas
%K HIV
%K Enzyme-linked immunoassays
%K Antibodies
%K Schistosomiasis
%K Schistosoma
%K Viral load
%K Schistosoma haematobium
%K Schistosoma mansoni
%U https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0006902