Comparison of anthelmintic effects of two doses of ivermectin on intestinal strongyloidiasis in patients negative or positive for anti-HTLV-1 antibody

Zaha, Osamu; Hirata, Tetsuya; Uchima, Nobuhumi; Kinjo, Fukunori; Saitô, Atsushi

doi:10.1007/s10156-004-0345-z

Cited by 34 publications

(24 citation statements)

References 12 publications

(15 reference statements)

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“…There is an increasing body of evidence regarding the strong association between S. stercoralis and HTLV-1 co-infection and hyperinfection syndrome [21][22][23][24][25][26] , which has been further strengthened by our striking result that a majority (72%) of the patients with hyperinfection were co-infected with HTLV-1. We also confirmed the well-described role of corticosteroids in triggering hyperinfection regardless of the presence of HTLV-1 co-infection.…”

Section: Discussionmentioning

confidence: 85%

“…This study was conducted in the Okinawa islands, a subtropical region of Japan, where both S. stercoralis and HTLV-1 are endemic and epidemiological studies have been thoroughly conducted [21][22][23][24] . There is an increasing body of evidence regarding the strong association between S. stercoralis and HTLV-1 co-infection and hyperinfection syndrome [21][22][23][24][25][26] , which has been further strengthened by our striking result that a majority (72%) of the patients with hyperinfection were co-infected with HTLV-1.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic and histopathological study on the duodenum of Strongyloides stercoralis hyperinfection

Kishimoto

Hokama²,

Hirata³

et al. 2008

WJG

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AIM:To investigate endoscopic and histopathological findings in the duodenum of patients with Strongyloides stercoralis (S. stercoralis ) hyperinfection. METHODS:Over a period of 23 years , we investigated 25 patients with S. stercoralis hyperinfection who had had an esophagogastroduodenoscopy before undergoing treatment for strongyloidiasis. The clinical and endoscopic findings were analyzed retrospectively. R E S U LT S :Tw e n t y -f o u r ( 9 6 % ) o f t h e p a t i e n t s investigated were under immunocompromised condition which was mainly due to a human T lymphotropic virus type 1 (HTLV-1) infection. The abnormal endoscopic findings, mainly edematous mucosa, white villi and erythematous mucosa, were observed in 23 (92%) patients. The degree of duodenitis including villous atrophy/destruction and inflammatory cell infiltration corresponded to the severity of the endoscopic findings. The histopathologic yield for identifying larvae was 71.4% by duodenal biopsy. The endoscopic findings of duodenitis were more severe in patients whose biopsies were positive for larvae than those whose biopsies were negative (Endoscopic severity score: 4.86 ± 2.47 vs 2.71 ± 1.38, P < 0.05). CONCLUSION:Our study clearly demonstrates that, in addition to stool analysis, endoscopic observation and biopsies are very important. We also emphasize that S. stercoralis and HTLV-1 infections should be ruled out before immunosuppressive therapy is administered in endemic regions.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Endoscopic and histopathological study on the duodenum of Strongyloides stercoralis hyperinfection

Kishimoto

Hokama²,

Hirata³

et al. 2008

WJG

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“…Therapy for ATLL was not initiated because of the risk of exacerbating the parasitic infection. Ivermectin, used for treatment of this patient, has been reported to cure 97-100% of patients with Strongyloidiasis, and is more effective than albendazole and better tolerated than thiabendazole [15].…”

Section: Discussionmentioning

confidence: 87%

Effect of treatment of Strongyloides infection on HTLV‐1 expression in a patient with adult T‐cell leukemia

et al. 2007

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Human T-cell leukemia virus type 1 (HTLV-1) is associated with adult T-cell leukemia-lymphoma (ATLL) in about 5% of infected individuals. Coinfection by Strongyloides stercoralis has been suggested to be a cofactor for development of ATLL. We describe a patient who presented with HTLV-1-associated chronic ATLL and Strongyloides infection. Studies of this patient's viral RNA levels demonstrated stimulation of HTLV-1 replication by Strongyloides, which resolved with anti-helminthic therapy. This case provides support for the hypothesis that Strongyloides is a cofactor for ATLL via T-cell stimulation. Am. J. Hematol. 82:929-931, 2007. V

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“…However, this response rate was lower than expected. Previous studies with the same drug regimens (2,10,14,25,41,43,61,62) reported eradication rates ranging from 85% to 100%. Given the absence of a reference diagnostic strategy, these studies employed a variety of follow-up protocols.…”

Section: Discussionmentioning

confidence: 93%

Evaluation of an Indirect Immunofluorescence Assay for Strongyloidiasis as a Tool for Diagnosis and Follow-Up

Boscolo

Gobbo

Mantovani

et al. 2007

Clin Vaccine Immunol

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The diagnostic accuracy of an indirect immunofluorescence antibody test (IFAT) for Strongyloides stercoralis at different serum antibody titers was evaluated. To assess diagnostic sensitivity, sera from 156 patients with known strongyloidiasis were collected. Negative control sera were obtained from a composite group of 427 subjects (blood donors and hospitalized patients). With an area under the receiver-operating characteristic plot of 0.98, the IFAT showed a high level of diagnostic accuracy for strongyloidiasis. An antibody titer of >1:20, with 97% sensitivity and 98% specificity, was identified as the diagnostic threshold with the best overall performance. Cross-reactions were evaluated with 41 additional samples from patients with other known helminth infections, and the IFAT detected low-titer positivity in only one subject with filariasis. A positive IFAT result at an antibody dilution of >1:80 was virtually 100% specific, with 71% sensitivity. To test the usefulness of the IFAT as a monitoring tool, the changes in specific-antibody titers after treatment in a group of 155 patients were evaluated. Seroreversion or a decrease in antibody titer of twofold or more was observed in 60% of the patients. Response to treatment was directly correlated to the initial antibody titer, and a baseline titer of >1:80 was identified as the best predictor of response. In conclusion, a positive IFAT result at an antibody dilution of >1:20 is the optimal cutoff for screening. A titer of >1:80, with virtually no false-positive result, is a reliable cutoff for a serological assessment of treatment efficacy and for inclusion in clinical trials.

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Comparison of anthelmintic effects of two doses of ivermectin on intestinal strongyloidiasis in patients negative or positive for anti-HTLV-1 antibody

Cited by 34 publications

References 12 publications

Endoscopic and histopathological study on the duodenum of Strongyloides stercoralis hyperinfection

Endoscopic and histopathological study on the duodenum of Strongyloides stercoralis hyperinfection

Effect of treatment of Strongyloides infection on HTLV‐1 expression in a patient with adult T‐cell leukemia

Evaluation of an Indirect Immunofluorescence Assay for Strongyloidiasis as a Tool for Diagnosis and Follow-Up

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