Schistosoma mansoni, nematode infections, and progression to active tuberculosis among HIV-1-infected Ugandans.
Rates of tuberculosis (TB) in Africa are highest among people infected with HIV. Searching for additional risk factors in a cohort of HIV-infected Ugandan adults, we previously found that a type 2 cytokine bias and eosinophilia were associated with progression to active TB. A possible role for helminth infection was assessed in this study. We analyzed TB incidence in 462 members of this cohort who were screened for filarial infections, gastrointestinal nematodes, and schistosomiasis. Progression to TB was not associated with gastrointestinal nematodes (rate ratio [RR], 1.18; confidence intervals [CIs], 0.66-2.10) or Mansonella perstans (RR, 0.42; CI, 0.13-1.34). A weak association between Schistosoma mansoni infection and TB was found (RR, 1.42; CI, 0.86-2.34); after adjusting for potential explanatory variables and using more stringent diagnostic criteria, the association was strengthened (RR, 2.31; 1.00-5.33). This analysis suggests an effect of S. mansoni infection on progression to active TB among HIV-1-infected Ugandans.
Brown
Michael
M
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom. michael.brown@lshtm.ac.uk
Miiro
George
G
Nkurunziza
Peter
P
Watera
Christine
C
Quigley
Maria A
MA
Dunne
David W
DW
Whitworth
James A G
JA
Elliott
Alison M
AM