Schistosomiasis and HIV-1 viral load in HIV-infected outpatients with immunological failure in Tanzania: a case-control study
Autor: | Bernard Desderius, Amon I. Marti, Jennifer A. Downs, Soledad Colombe, Samuel E. Kalluvya, Govert J. van Dam, Mwanaisha Seugendo, Claudia J. de Dood, Peter Masikini, Paul L. A. M. Corstjens |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
0301 basic medicine
Adult medicine.medical_specialty Anemia 030106 microbiology Schistosomiasis HIV Infections Tanzania Virus lcsh:Infectious and parasitic diseases 03 medical and health sciences 0302 clinical medicine Medical microbiology Acquired immunodeficiency syndrome (AIDS) Outpatients Circulating anodic antigen medicine Humans lcsh:RC109-216 Viral load 030212 general & internal medicine Schistosoma sp business.industry Case-control study medicine.disease Infectious Diseases Parasitology Treatment failure Case-Control Studies Immunology HIV-1 business ART Research Article |
Zdroj: | BMC Infectious Diseases, 19 BMC Infectious Diseases BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-7 (2019) |
Popis: | Background Schistosoma sp. infection has been shown to interact with HIV-1 by modifying susceptibility to the virus and impacting AIDS outcome, but very little is known about the potential impact of Schistosoma sp. infection on the efficiency of antiretroviral treatment (ART) in HIV-1 infected individuals. One study suggested increased immunological failure in patients infected with schistosomes compared to those uninfected. To our knowledge, no report exists on the virological response to ART in schistosome-infected individuals. In addition, viral load in HIV-1 infected individuals changes over the course of the HIV infection. This study assessed the impact of HIV-1/Schistosoma sp. co-infections on viral load in people with immunological failure on ART, taking into account the duration of HIV-1 infection. Methods We enrolled HIV-1 infected Tanzanian adults over 18 years of age who had used first line ART for more than 6 months and were identified to have immunological failure by the WHO criteria (50% drop from peak CD4 count, or CD4 count equal to or below baseline after 6 months of ART, or CD4 count below 100cells/mm3 after 1 year of ART). Patients were also tested for schistosome infection by microscopy for ova in urine and stool and by circulating anodic antigen (CAA) levels in serum. The duration of HIV-1 infection was calculated using baseline CD4+ T-cell (CD4) counts determined at enrollment. Univariable and multivariable analyses were conducted to compare viral loads in schistosome infected and uninfected patients. Results A total of 188 patients were enrolled. After univariable analysis, female sex, lower peak CD4 counts, lower current CD4 counts, anemia, and shorter time infected with HIV-1 were all significantly associated with higher viral load. Schistosome infection was not associated with viral load even after adjusting for sex, current CD4 counts and duration of HIV-1 infection. Conclusions The current study of HIV-infected patients with immunological failure on ART suggests that once ART is introduced, ART is the dominant driver of viral load and schistosome infection may no longer have an impact. |
Databáze: | OpenAIRE |
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