title: Association between Taenia solium infection and HIV/AIDS in northern Tanzania: a matched cross sectional-study.
abstract: BACKGROUND
  The frequency of Taenia solium, a zoonotic helminth, is increasing in many countries of sub-Saharan Africa, where the prevalence of the human immunodeficiency virus (HIV) is also high. However, little is known about how these two infections interact. The aim of this study was to compare the proportion of HIV positive (+) and negative (-) individuals who are infected with Taenia solium (TSOL) and who present with clinical and neurological manifestations of cysticercosis (CC).
  
  
  METHODS
  In northern Tanzania, 170 HIV+ individuals and 170 HIV- controls matched for gender, age and village of origin were recruited. HIV staging and serological tests for TSOL antibodies (Ab) and antigen (Ag) were performed. Neurocysticercosis (NCC) was determined by computed tomography (CT) using standard diagnostic criteria. Neurological manifestations were confirmed by a standard neurological examination. In addition, demographic, clinical and neuroimaging data were collected. Further, CD4+cell counts as well as information on highly active antiretroviral treatment (HAART) were noted.
  
  
  RESULTS
  No significant differences between HIV+ and HIV- individuals regarding the sero-prevalence of taeniosis-Ab (0.6% vs 1.2%), CC-Ab (2.4% vs 2.4%) and CC-Ag (0.6% vs 0.0%) were detected. A total of six NCC cases (3 HIV+ and 3 HIV-) were detected in the group of matched participants. Two individuals (1 HIV+ and 1 HIV-) presented with headaches as the main symptom for NCC, and four with asymptomatic NCC. Among the HIV+ group, TSOL was not associated with CD4+cell counts, HAART duration or HIV stage.
  
  
  CONCLUSIONS
  This study found lower prevalence of taeniosis, CC and NCC than had been reported in the region to date. This low level of infection may have resulted in an inability to find cross-sectional associations between HIV status and TSOL infection or NCC. Larger sample sizes will be required in future studies conducted in that area to conclude if HIV influences the way NCC manifests itself.
authors.affiliation: Department of Neurology, University Hospital, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany. veronika.schmidt@tum.de.
authors.forename: Veronika
authors.initials: V
authors.lastname: Schmidt
authors.affiliation: Department of Neurology, University Hospital, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Kositz
authors.affiliation: Department of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Herbinger
authors.affiliation: Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
authors.forename: Hélène
authors.initials: H
authors.lastname: Carabin
authors.affiliation: Muhimbili Medical Research Centre, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania.
authors.forename: Bernard
authors.initials: B
authors.lastname: Ngowi
authors.affiliation: HIV Care and Treatment Centre, Haydom Lutheran Hospital, Haydom, Tanzania.
authors.forename: Ezra
authors.initials: E
authors.lastname: Naman
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, USA.
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Wilkins
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, USA.
authors.forename: John
authors.initials: J
authors.lastname: Noh
authors.affiliation: Department of Neurology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: William
authors.initials: W
authors.lastname: Matuja
authors.affiliation: Department of Neurology, University Hospital, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany.|Centre of Global Health, University of Oslo, Oslo, Norway.
authors.forename: Andrea Sylvia
authors.initials: AS
authors.lastname: Winkler
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000821:virology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D003430:Cross-Sectional Studies; D003551:Cysticercosis / Q000453:epidemiology* / Q000469:parasitology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D006679:HIV Seropositivity / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000453:epidemiology / Q000469:parasitology; D015995:Prevalence; D041201:Taenia solium / Q000302:isolation & purification*; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
keywords: AIDS; Co-infection; Cysticercosis; HIV; Helminth; Neurocysticercosis; Prevalence; Taenia solium; Taeniosis; Tapeworm