Prevalence of Strongyloides stercoralis infection among HIV-positive immigrants attending two Italian hospitals, from 2000 to 2009

Author： Mascarello M Gobbi F Angheben A Gobbo M Gaiera G Pegoraro M Lanzafame M Buonfrate D Concia E Bisoffi Z

Publisher： Maney Publishing

ISSN： 1364-8594

Source： Annals of Tropical Medicine and Parasitology, Vol.105, Iss.8, 2011-12, pp. : 617-623

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

Previous Menu Next

Abstract

In patients with Strongyloides stercoralis infection, a dysregulation of host immunity can lead to hyperinfection syndrome (HS) and disseminated strongyloidiasis (DS), characterized by high fatality rate. HS has been reported in HIV-positive patients following use of corticosteroids or during immune reconstitution inflammatory syndrome (IRIS). A retrospective study was conducted to estimate the prevalence of S. stercoralis infection among HIV-positive immigrants, attending two Italian hospitals. From January 2000 to August 2009, 138 HIV-positive immigrants were systematically screened for strongyloidiasis, as a part of their routine care, with an indirect immunofluorescent antibody test (IFAT) developed at the Centre for Tropical Diseases, Sacro Cuore Hospital of Negrar, Verona. The majority were also submitted to stool examination. Fifteen (11%) resulted infected by S. stercoralis, of whom four (27%) had a negative serology (diagnosis made with stool examination). A higher eosinophil count (0·94 versus 0·24×10⁹/l, P<0·01) and="" more="" frequent="" gastrointestinal="" and="" cutaneous="" symptoms="" (odds="" ratio:="" 4·8="" and="" 5·8,="" respectively)="" were="" found="" in="" patients="" with="" strongyloidiasis="" compared="" with="" controls.="" the="" ifat="" is="" more="" sensitive="" than="" direct="" parasitological="" methods.="" the="" proportion="" of="" false="" negative="" results="" was="" higher="" than="" expected="" based="" on="" the="" theoretical="" test="" sensitivity.="" considering="" the="" high="" prevalence="" detected="" and="" the="" apparent,="" lower="" sensitivity="" of="" serology,="" we="" propose="" a="" systematic="" screening="" for="">Strongyloides infection, with both serology and stool culture, for all HIV-positive immigrants coming from endemic areas.