Should we look for Strongyloides stercoralis in foreign-born HIV-infected persons?

J Immigr Minor Health. 2013 Aug;15(4):796-802. doi: 10.1007/s10903-012-9756-6.

Abstract

The objective was to evaluate the implementation of a systematic Strongyloides stercoralis screening programme in HIV infected immigrants attending an HIV Unit in Spain. An enzyme-linked immunosorbent assay (ELISA) was performed to assess the presence of Strongyloides IgG. Patients with a positive serology were treated with ivermectin; serologic follow-up testing was performed. 237 patients were screened (65.4 % men). Origin: 64.1 % came from Latin America, 16.5 % from Sub-Saharan Africa, 9.7 % from the Caribbean, 9.7 % from other areas. Strongyloides stercolaris IgG was positive in 13 cases (5.5 %). In the multivariate analysis, factors associated with a positive Strongyloides serology were illiteracy (OR: 23.31; p = 0.009) and eosinophilia (OR: 15.44; p < 0.0001). Nine of the 13 patients positive for S. stercoralis IgG and treated with ivermectin had a follow up serologic test: 77.8 % achieved a serologic response (55.5 % seroreversion). Screening of HIV-positive immigrants may be desirable, at least in those with higher risk of hyperinfection syndrome. Serologic testing seems a useful tool in both diagnosis and follow-up of these patients.

MeSH terms

  • Adult
  • Africa South of the Sahara / ethnology
  • Animals
  • Caribbean Region / ethnology
  • Cross-Sectional Studies
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Immunoglobulin G / analysis
  • Ivermectin / therapeutic use
  • Latin America / ethnology
  • Longitudinal Studies
  • Male
  • Mass Screening / standards
  • Middle Aged
  • Spain
  • Strongyloides stercoralis / isolation & purification*
  • Strongyloidiasis / diagnosis*
  • Strongyloidiasis / drug therapy
  • Strongyloidiasis / ethnology*

Substances

  • Immunoglobulin G
  • Ivermectin