PREVALENCE AND PREDICTORS OF INTESTINAL HELMINTH INFECTIONS AMONG HUMAN IMMUNODEFICIENCY VIRUS TYPE 1–INFECTED ADULTS IN AN URBAN AFRICAN SETTING

KAYVON MODJARRAD Department of Epidemiology, and Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham Alabama; Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama; Department of Medicine, University Teaching Hospital, Lusaka, Zambia

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ISAAC ZULU Department of Epidemiology, and Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham Alabama; Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama; Department of Medicine, University Teaching Hospital, Lusaka, Zambia

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DAVID T. REDDEN Department of Epidemiology, and Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham Alabama; Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama; Department of Medicine, University Teaching Hospital, Lusaka, Zambia

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LUNGOWE NJOBVU Department of Epidemiology, and Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham Alabama; Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama; Department of Medicine, University Teaching Hospital, Lusaka, Zambia

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DAVID O. FREEDMAN Department of Epidemiology, and Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham Alabama; Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama; Department of Medicine, University Teaching Hospital, Lusaka, Zambia

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STEN H. VERMUND Department of Epidemiology, and Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham Alabama; Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama; Department of Medicine, University Teaching Hospital, Lusaka, Zambia

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Sub-Saharan Africa is disproportionately burdened by intestinal helminth and human immunodeficiency virus (HIV)-1 infection. Recent evidence suggests detrimental immunologic effects from concomitant infection with the two pathogens. Few studies, however, have assessed the prevalence of and predictors for intestinal helminth infection among HIV-1–infected adults in urban African settings where HIV infection rates are highest. We collected and analyzed sociodemographic and parasitologic data from 297 HIV-1–infected adults (mean age = 31.1 years, 69% female) living in Lusaka, Zambia to assess the prevalence and associated predictors of helminth infection. We found at least one type of intestinal helminth in 24.9% of HIV-infected adults. Thirty-nine (52.7%) were infected with Ascaris lumbricoides, and 29 (39.2%) were infected with hookworm. More than 80% were light-intensity infections. A recent visit to a rural area, food shortage, and prior history of helminth infection were significant predictors of current helminth status. The high helminth prevalence and potential for adverse interactions between helminths and HIV suggests that helminth diagnosis and treatment should be part of routine HIV care.

Author Notes

Reprint requests: Kayvon Modjarrad, Department of Medicine, Division of Geographic Medicine, University of Alabama at Birmingham, 1530 3rd Avenue South, BBRB 206B, Birmingham, AL 35294-2170.
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