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Strongyloidiasis associated with human T-cell lymphotropic virus type I infection in a nonendemic area
Abstract:
Concomitant strongyloidiasis and human T-cell lymphotropic virus type I (HTLV-I) infection has been reported from areas in Japan where both organisms are endemic. We present four cases of concomitant infection with these organisms from an area that is not endemic for Strongyloides stercoralis. Three of the four patients had adult T-cell leukemia, an aggressive neoplasm resulting from HTLV-I infection, while the other was an asymptomatic carrier of HTLV-I. Three of the patients had spent their childhoods in an endemic location for both organisms, suggesting an initial infection at that time. Three patients were symptomatic from their parasitism. We conclude that strongyloidiasis may be found in nonendemic locations in patients with either adult T-cell leukemia or an asymptomatic HTLV-I carrier state. Whether infestation with this parasite contributes to the leukemogenesis of HTLV-I, as postulated by others, cannot at this time be determined.
Insights
Strongyloidiasis can occur in non-endemic areas in individuals with human T-cell lymphotropic virus type I (HTLV-I) infection, including those with adult T-cell leukemia. This highlights the importance of considering co-infections in diverse geographic settings.
Area of Science:
- Infectious Diseases
- Virology
- Parasitology
Background:
- Human T-cell lymphotropic virus type I (HTLV-I) is endemic in certain regions, often co-occurring with Strongyloides stercoralis.
- Concomitant infections are typically reported from areas where both pathogens are endemic.
Observation:
- This study presents four cases of co-infection with Strongyloides stercoralis and HTLV-I from a non-endemic region for the parasite.
- Three patients had adult T-cell leukemia (ATL), a malignancy associated with HTLV-I, and one was an asymptomatic HTLV-I carrier.
- Initial exposure to both pathogens likely occurred during childhood in endemic areas for three of the patients.
Findings:
- Strongyloidiasis can be diagnosed in non-endemic geographical locations in individuals with HTLV-I infection.
- The presence of Strongyloides stercoralis infection was noted in patients with both symptomatic ATL and asymptomatic HTLV-I carriage.
Implications:
- Clinicians should consider strongyloidiasis in patients with HTLV-I, regardless of geographical origin.
- The potential role of Strongyloides stercoralis in the leukemogenesis of HTLV-I warrants further investigation.