Schistosoma mansoni and HIV acquisition in fishing communities of Lake Victoria, Uganda: a nested case-control study.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
These results do not support the hypothesis that S. mansoni infection promotes HIV acquisition.
UVRI-IAVI HIV Vaccine Program, Entebbe, Uganda.
Ali
A
Ssetaala
MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.|London School of Hygiene & Tropical Medicine, London, UK.
Jessica
J
Nakiyingi-Miiro
MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
Gershim
G
Asiki
MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
Nassim
N
Kyakuwa
UVRI-IAVI HIV Vaccine Program, Entebbe, Uganda.
Juliet
J
Mpendo
Leiden University Medical Center, Leiden, The Netherlands.
Govert J
GJ
Van Dam
Leiden University Medical Center, Leiden, The Netherlands.
Paul L
PL
Corstjens
MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
Pietro
P
Pala
International AIDS Vaccine Initiative, New York, NY, USA.
Leslie
L
Nielsen
International AIDS Vaccine Initiative, New York, NY, USA.
Jan De
J
Bont
Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Giuseppe
G
Pantaleo
UVRI-IAVI HIV Vaccine Program, Entebbe, Uganda.|Makerere College of Health Sciences, School of Public Health, Kampala, Uganda.
Noah
N
Kiwanuka
MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.|London School of Hygiene & Tropical Medicine, London, UK.|Uganda Virus Research Institute, Entebbe, Uganda.
Pontiano
P
Kaleebu
MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.|Uganda Virus Research Institute, Entebbe, Uganda.
Anatoli
A
Kamali
MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.|London School of Hygiene & Tropical Medicine, London, UK.
Alison M
AM
Elliott

Schistosoma mansoni
; 
VIH
; HIV; Ouganda; Schistosoma mansoni; Uganda; antigène anodique circulant; antígeno anódico circulante; circulating anodic antigen; communautés de pêcheurs; comunidades de pescadores; fishing communities; sensibilité; susceptibilidad; susceptibility