Treatment failure in intestinal strongyloidiasis: an indicator of HTLV-I infection

Terashima, Angélica; Alvarez, Humberto; Tello, Raúl; Infante, Rosa; Freedman, David O.; Gotuzzo, Eduardo

doi:10.1016/s1201-9712(02)90132-3

Cited by 54 publications

(34 citation statements)

References 9 publications

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“…40 Patients who fail to clear the parasite after two doses of ivermectin should be tested for HTLV-I infection. 22 A concerted effort to look for other causes of eosinophilia is recommended if it persists after three months despite a serological response to ivermectin treatment.…”

Section: How Is Treatment Efficacy Assessed?mentioning

confidence: 99%

Strongyloides stercoralis infection

Greaves

Coggle

Pollard

et al. 2013

BMJ

233

188

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Objectives To assess the effect of treatment with ivermectin on the prevalence of S. stercoralis infection in an Australian Aboriginal population over a three year period, and to assess the validity of using a lower ELISA cutoff in diagnosis. Methods A three-year cohort study of 259 adult Australian Aboriginals living in a remote community in northern Australia. S stercoralis infection was diagnosed using commercial ELISA testing, and employed a lower threshold for treatment than that recommended. Follow up was conducted at 6 months and 3 years following ivermectin treatment. Findings Treatment with ivermectin was highly effective and resulted in a sustained fall in the prevalence of infection in the study group (Initial prevalence 35.3%, 3 year prevalence 5.8%, McNemar's chi 2 = 56.5, p<0.001). Results of treatment suggested use of a lower ELISA threshold for treatment was valid in this setting. Follow up identified a small group of subjects with persistently positive ELISA serology despite repeated treatment.

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Section: How Is Treatment Efficacy Assessed?mentioning

confidence: 99%

Strongyloides stercoralis infection

Greaves

Coggle

Pollard

et al. 2013

BMJ

233

188

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“…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]. For the above reasons, it is reasonable to investigate HTLV-1 infection in patients with Strongyloides, especially those who fail therapy [57].…”

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

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147

126

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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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“…Treatment failure has been associated previously with HTLV-1 infection and steroid use. 18,21 In our cases, failure was associated with HTLV-1 infection of only one patient. Ivermectin failure in the other three cases was likely related to corticosteroid use, which may impair host immune responses or alter parasite population kinetics.…”

Section: Discussionmentioning

confidence: 55%

Non-Oral Treatment with Ivermectin for Disseminated Strongyloidiasis

Fusco¹,

Downs²,

Satlin³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Critically ill patients with disseminated strongyloidiasis may not be candidates for oral treatment. We report four patients with disseminated strongyloidiasis, believed to be unable to absorb oral therapy, who were treated with ivermectin by rectal and/or subcutaneous administration. Obtaining subcutaneous ivermectin and dosing it appropriately is a challenge. These cases underscore the need for improved access to subcutaneous ivermectin and more pharmacological data to guide use of this treatment approach.

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Treatment failure in intestinal strongyloidiasis: an indicator of HTLV-I infection

Abstract: We recommend that all patients with uncomplicated intestinal strongyloidiasis, who fail standard therapy, be studied for HTLV-I infection.

Cited by 54 publications

References 9 publications

Strongyloides stercoralis infection

Strongyloides stercoralis infection

Update on Strongyloidiasis in the Immunocompromised Host

Non-Oral Treatment with Ivermectin for Disseminated Strongyloidiasis

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