923 Emergence of a New Opportunistic Infection in Europe: Hepatic Alveolar Echinococcosis. A Fifty-Case Report

Chauchet, Adrien; Grenouillet, Frédéric; Knapp, Jenny; Richou, Carine; Delabrousse, É; Dentan, Charlotte; Capelle, S.; Martino, Vincent Di; Deconinck, Éric; Blagosklonov, Oleg; Vuitton, DA; Bresson‐Hadni, Solange

doi:10.1016/s0168-8278(13)60925-3

Cited by 9 publications

(7 citation statements)

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“…The latent period may be shorter in case of immune suppression as in patients with liver transplantation for AE, where recurrence is observed less than 2 years after transplantation (Koch et al 2003). Parasite growth is also faster in patients with immune suppressionassociated conditions such as cancer, chronic inflammatory diseases, kidney or heart transplantation, or hematological disorders, sometimes with unexpected "acute" clinical presentation (Chauchet et al 2013). Conversely, population-based mass screening in endemic areas revealed that infection may never be followed by disease in most cases (Bartholomot et al 2002;Yang et al 2006a;Bresson-Hadni et al 1994).…”

Section: Alveolar Echinococcosis Lesions and Theirmentioning

confidence: 99%

“…Lack of symptoms is more frequent in immune-suppressed patients. In these patients, the course of AE seems faster; clinical symptoms, if any, may mimic liver abscess; and both imaging and serological diagnoses may be more difficult to interpret Gruener et al 2008;Chauchet et al 2013).…”

Section: Clinical Manifestations Of Aementioning

confidence: 99%

“…Cross-reactivity of highly sensitive tests may also be used as a diagnostic tool in particular situations, such as recurrence of AE lesions after liver transplantation (Koch et al 2003) and in AE patients with immune suppression (Chauchet et al 2013). 3.…”

Section: Serologymentioning

confidence: 99%

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Echinococcosis

Tamarozzi

Brunetti

Vuitton

2014

Helminth Infections and Their Impact on Global Public Health

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Cystic echinococcosis (CE) and alveolar echinococcosis (AE) are zoonoses of great medical and veterinary importance, caused by Echinococcus granulosus and E. multilocularis, respectively. The life cycle of these parasites develops between the dog and other canids, which harbor the adult tapeworm in the intestine, and mammal intermediate hosts (including humans as dead-end occasional hosts) where the larval form, or metacestode, develops in different organs.The impact of CE and AE on human health is important, with an estimated 1.2 million people affected and 3.6 million DALYs lost globally for CE and 666,434 DALYs for AE.We describe epidemiology, host's immune response to parasite, clinical manifestations, diagnosis, and treatment of both CE and AE.

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Section: Alveolar Echinococcosis Lesions and Theirmentioning

confidence: 99%

Section: Clinical Manifestations Of Aementioning

confidence: 99%

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Echinococcosis

Tamarozzi

Brunetti

Vuitton

2014

Helminth Infections and Their Impact on Global Public Health

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“…These figures, however, do not reflect the situation of the actual population at risk; far higher incidences, from 4.7 to 8.1 cases per 100,000 inhabitants/year, are observed in areas where humans are directly exposed to E. multilocularis infection in the same countries [ 39 , 47 , 49 ]. In Europe and Canada, emergence and geographical increase in endemicity have been reported [ 7 , 9 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Echinococcusmetacestode: in search of viability markers

et al. 2014

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Epidemiological studies have demonstrated that most humans infected with Echinococcus spp. exhibit resistance to disease. When infection leads to disease, the parasite is partially controlled by host immunity: in case of immunocompetence, the normal alveolar echinococcosis (AE) or cystic echinococcosis (CE) situation, the metacestode grows slowly, and first clinical signs appear years after infection; in case of impaired immunity (AIDS; other immunodeficiencies), uncontrolled proliferation of the metacestode leads to rapidly progressing disease. Assessing Echinococcus multilocularis viability in vivo following therapeutic interventions in AE patients may be of tremendous benefit when compared with the invasive procedures used to perform biopsies. Current options are F18-fluorodeoxyglucose-positron emission tomography (FDG-PET), which visualizes periparasitic inflammation due to the metabolic activity of the metacestode, and measurement of antibodies against recEm18, a viability-associated protein, that rapidly regresses upon metacestode inactivation. For Echinococcus granulosus, similar prognosis-associated follow-up parameters are still lacking but a few candidates may be listed. Other possible markers include functional and diffusion-weighted Magnetic Resonance Imaging (MRI), and measurement of products from the parasite (circulating antigens or DNA), and from the host (inflammation markers, cytokines, or chemokines). Even though some of them have been promising in pilot studies, none has been properly validated in an appropriate number of patients until now to be recommended for further use in clinical settings. There is therefore still a need to develop reliable tools for improved viability assessment to provide the sufficient information needed to reliably withdraw anti-parasite benzimidazole chemotherapy, and a basis for the development of new alternative therapeutic tools.

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“…Представляется очевидным, что в большинстве случаев альвеококкоза и эхинококкоза врождѐнный или приобретѐнный иммунитет способствует борьбе с этими заболеваниями как в ранней, так и в поздней стадии инвазии. С другой стороны, ослабление клеточного иммунитета, например в случае ВИЧ-инфекции, приводит к быстрому и неконтролируемому росту и диссеминации паразита при заражении альвеококкозом [22,41].…”

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