Enteroparasitosis prevalence and parasitism influence in clinical outcomes of tuberculosis patients with or without HIV co-infection in a reference hospital in Rio de Janeiro (2000-2006)

Abstract

Tuberculosis and intestinal parasites affect primarily low social and economic level populations, living clustered in precarious habitational settings. One of the interesting aspects of this interaction is the parasitism influence in cellular response to tuberculosis. In the present study, we evaluated the prevalence of enteroparasitosis in tuberculosis patients, HIV-infected and non HIV infected, and we observed the influence of helminth presence in the response to tuberculin skin test (TST) and tuberculosis clinical outcomes. From 607 clinical records reviewed, 327 individuals met the study inclusion criteria and did not present any exclusion criteria. The prevalence of enteroparasites observed was 19.6%. There was no significant association among TST result and the variables related to the presence of: helminthes, protozoa, and stool test for parasites result (p>0.5). Considering the survival of this cohort, we may observe that there is no significant difference (p>0.05) between the survival curves of parasited and non parasited individuals. Solely the variable "eosinophils" presents a statistically significant association (p<0.001) with helminthes, all other associations are considered not significant. Our findings neither show an association between helminthic infection and a favorable tuberculosis outcome, nor between parasitism and TST response, unlike other in vitro studies. Apparently, experimental data do not correspond to the clinical findings.

Aids e tuberculose: a coinfecção vista pela perspectiva da qualidade de vida dos indivíduos

“…As for education and income, data agree with the social profile of the epidemic of Aids and TB, which in Brazil strike mainly the less economically favored classes of the population (3,(9)(10) . Even so, in the group of coinfected individuals, these indicators were even lower than the others.…”

Helminth-Tuberculosis Co-infection: An Immunologic Perspective

“…In contrast, coincident lymphatic filarial infection had no significant influence on tuberculin skin test positivity in a population endemic for Wuchereria bancrofti and hookworm infections and tuberculosis in South India [52]. Similar findings were seen in a study of patients in Brazil [53] and Peru [54], in which there was no difference in skin test reactivity between those with intestinal parasites and those without. A more recent study in South Africa similarly revealed no significant effect of antihelmintic treatment on tuberculin skin test or IGRAs in children [55].…”

“…Similarly, in Ethiopia, a significant association was observed between the incidence of TB disease and the presence of intestinal helminth infection [57]. However, in HIV positive populations in both Uganda and Brazil, neither gastrointestinal parasitic infections nor Mansonella perstans (a filarial nematode) was associated with progression to active TB, though in Uganda there was a relationship between having schistosomiasis and progression from LTBI to active TB [53, 58]. Interestingly, eosinophilia, that typically accompanies helminth infections, was found to be strongly associated with the risk of active TB in Africa [59].…”

Effect of Ascaris Lumbricoides specific IgE on tuberculin skin test responses in children in a high-burden setting: a cross-sectional community-based study

“…The current limited evidence supports a potential immune modulating effect of helminths on mycobacterial immune responses in humans [15,21,23], although contradictory evidence also exists [24,25]. We therefore investigated the effect of an Ascaris- specific IgE positive status on a commonly used marker of M.tb infection (TST), in children in a setting with a high burden of tuberculosis.…”