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

Ratner, Lee; Grant, Christian; Zimmerman, Brian; Fritz, Joseph M.; Weil, Gary J.; Denes, Alex E.; Suresh, Rama; Campbell, Nancy; Jacobson, Steve; Lairmore, Michael Dale

doi:10.1002/ajh.20929

Cited by 18 publications

(14 citation statements)

References 23 publications

(28 reference statements)

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“…Some studies have suggested that S. stercoralis infection promotes development of ATL in HTLV-1 infected individuals [8,9,10], but this hypothesis has been disputed on the grounds that ATL patients infected with Strongyloides have improved responses to chemotherapy [11], and HTVL-1 carriers coinfected with Strongyloides have a lower proviral loads than those with HTVL-1 alone [12]. …”

Section: Discussionmentioning

confidence: 99%

Disseminated Strongyloides stercoralis Infection in HTLV-1-Associated Adult T-Cell Leukemia/Lymphoma

et al. 2011

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A 55-year-old woman with human T-cell lymphotropic virus type-1 (HTLV-1)-associated adult T-cell leukemia (ATL) and a history of previously treated Strongyloides stercoralis infection received anti-CD52 monoclonal antibody therapy with alemtuzumab on a clinical trial. After an initial response, she developed ocular involvement by ATL. Alemtuzumab was stopped and high-dose corticosteroid therapy was started to palliate her ocular symptoms. Ten days later, the patient developed diarrhea, vomiting, fever, cough, skin rash, and a deteriorating mental status. She was diagnosed with disseminated S. stercoralis. Corticosteroids were discontinued and the patient received anthelmintic therapy with ivermectin and albendazole with complete clinical recovery.

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Section: Discussionmentioning

confidence: 99%

Disseminated Strongyloides stercoralis Infection in HTLV-1-Associated Adult T-Cell Leukemia/Lymphoma

et al. 2011

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“…Interestingly, Strongyloides infection can influence the natural history of HTLV-1 infection by promoting polyclonal proliferation of HTLV-1-infected cells through activation of the IL-2/IL-2R system and can be a cofactor for developing HTLV-1-associated diseases [53]. Also, after treating Strongyloides with ivermectin in a patient with HTLV-1-associated adult T-cell leukemialymphoma, HTLV-1 RNA viral load reduced dramatically, suggesting that Strongyloides was a potent stimulus for virus expression [55]. On the other hand, a patient with Strongyloides who failed therapy with ivermectin, thiabendazole, or albendazole should be considered HTLV-1 coinfected until proven otherwise [47,52,56].…”

Section: Strongyloides and Htlv-1 Coinfectionmentioning

confidence: 99%

Update on Strongyloidiasis in the Immunocompromised Host

Marcos

Terashima

Canales

et al. 2010

Curr Infect Dis Rep

141

124

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Immunocompromised persons are the most vulnerable population at risk for developing life-threatening clinical syndromes associated with strongyloidiasis, such as hyperinfection syndrome (HS) or dissemination. This review focuses on describing Strongyloides infection in the immunocompromised host, including immune response against this infection, analyzing the cases with HS published during the past 4 years in the United States, and describing the most sensitive diagnostic tools and the most effective treatment for each clinical syndrome. Strongyloidiasis is becoming an important parasitic disease in the United States, especially in the immunocompromised immigrant population. Because the transplant population is particularly at risk for developing HS, both recipients and donors should be screened for Strongyloides. Clinicians should also be aware that the development of HS can follow unexpectedly a few days after appropriate anthelminthic therapy. Highly sensitive screening tests are still not available in the major tertiary medical centers. Parenteral ivermectin has been used in some severe cases. Further therapy developments and improving diagnostic tools are warranted.

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“…HTLV-1 enhances susceptibility to Strongyloides infection as a result of diminished immunoglobulin E levels and a bias toward a T helper 1 rather than T helper 2 immune response [28]. In turn, Strongyloides may facilitate HTLV-1 virus replication, as suggested by a measurable decline in HTLV-1 messenger RNA levels in one patient after treatment with ivermectin [29]. Strongyloides has been proposed to accelerate the progression of HTLV-1 to adult Tcell leukemia in coinfected patients [30].…”

Section: Immunocompromised Conditionsmentioning

confidence: 99%

Strongyloides stercoralis infection in the immunocompromised host

Ramanathan

Nutman²

2008

Curr Infect Dis Rep

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Strongyloides stercoralis is an intestinal nematode acquired in the tropics or subtropics. Most often, it causes chronic, asymptomatic infection, but a change in immune status can increase parasite numbers, leading to hyperinfection syndrome, dissemination, and death if unrecognized. Corticosteroid use is most commonly associated with hyperinfection syndrome. Diagnosis of Strongyloides infection is based on serology and serial stool examinations for larvae. The treatment of choice for chronic, asymptomatic infection is oral ivermectin. Alternative pharmacologic agents include albendazole and thiabendazole. For hyperinfection syndrome, ivermectin remains the drug of choice, though therapy duration must be individualized with the end point being complete parasite eradication. Recurrent strongyloidiasis should prompt an evaluation for human T-cell lymphotropic virus type 1 coinfection. No test of cure is currently available, although immunoglobulin G antibody levels have been shown to decline within 6 months of successful treatment.

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

Cited by 18 publications

References 23 publications

Disseminated <i>Strongyloides stercoralis</i> Infection in HTLV-1-Associated Adult T-Cell Leukemia/Lymphoma

Disseminated <i>Strongyloides stercoralis</i> Infection in HTLV-1-Associated Adult T-Cell Leukemia/Lymphoma

Update on Strongyloidiasis in the Immunocompromised Host

Strongyloides stercoralis infection in the immunocompromised host

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