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. 2021 Jun 30;8(7):ofab349.
doi: 10.1093/ofid/ofab349. eCollection 2021 Jul.

Female Genital Schistosomiasis and HIV-1 Incidence in Zambian Women: A Retrospective Cohort Study

Amy S Sturt  1 , Emily L Webb  2 , Comfort R Phiri  3 , Maina Mudenda  4 , Joyce Mapani  4 , Barry Kosloff  1   3 , Maina Cheeba  3 , Kwame Shanaube  3 , Justin Bwalya  3 , Eyrun F Kjetland  5   6 , Suzanna C Francis  2 , Paul L A M Corstjens  7 , Govert J van Dam  8 , Lisette van Lieshout  8 , Isaiah Hansingo  4 , Helen Ayles  1   3 , Richard J Hayes  2 , Amaya L Bustinduy  1
Affiliations

Female Genital Schistosomiasis and HIV-1 Incidence in Zambian Women: A Retrospective Cohort Study

Amy S Sturt et al. Open Forum Infect Dis. .

Abstract

Background: Female genital schistosomiasis (FGS) has been associated with prevalent HIV-1. We estimated the incidence of HIV-1 infection in Zambian women with and without FGS.

Methods: Women (aged 18-31, nonpregnant, sexually active) were invited to participate in this study in January-August 2018 at the final follow-up of the HPTN 071 (PopART) Population Cohort. HIV-1-negative participants at enrollment (n = 492) were included in this analysis, with testing to confirm incident HIV-1 performed in HPTN 071 (PopART). The association of incident HIV-1 infection with FGS (Schistosoma DNA detected by polymerase chain reaction [PCR] in any genital specimen) was assessed with exact Poisson regression.

Results: Incident HIV-1 infections were observed in 4.1% (20/492) of participants. Women with FGS were twice as likely to seroconvert as women without FGS but with no statistical evidence for a difference (adjusted rate ratio, 2.16; 95% CI, 0.21-12.30; P = .33). Exploratory analysis suggested an association with HIV-1 acquisition among women with ≥2 positive genital PCR specimens (rate ratio, 6.02; 95% CI, 0.58-34.96; P = .13).

Conclusions: Despite higher HIV seroconversion rates in women with FGS, there was no statistical evidence of association, possibly due to low power. Further longitudinal studies should investigate this association in a setting with higher schistosomiasis endemicity.

Keywords: HIV incidence; PCR; Schistosoma haematobium; female genital schistosomiasis; parasite; polymerase chain reaction.

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Figures

Figure 1.
Figure 1.
Female genital schistosomiasis categories and Venn diagram illustrating results by diagnostic test type. A, Female genital schistosomiasis diagnostic categories. B, Participants in the diagnostic categories by test result. Participants within the FGS and probable/possible FGS categories do not overlap. Abbreviations: CAA, circulating anodic antigen; FGS, female genital schistosomiasis; PCR, polymerase chain reaction.
Figure 2.
Figure 2.
Study flow diagram. Not visited (n = 189): the participant was not visited before the study closed for enrollment. Visited but not contacted (n = 110): a visit was made to the study household, but the participant could not be located (70), had relocated (39), or died (1). Contacted & not immediately enrolled (n = 120): visited but not recruited (42), out of town (18), declined to participate (60). Contacted & ineligible (n = 41): virgin (16), pregnant (17), over 31 (8). Abbreviation: FGS, female genital schistosomiasis.
See this image and copyright information in PMC

References

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