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Should We Screen HIV-Positive Migrants for Strongyloidiasis?
Caroline Theunissen1, Emmanuel Bottieau1, Marjan Van Esbroeck1
1Institute of Tropical Medicine, Department of Clinical Sciences, 2000 Antwerp, Belgium.
Pathogens (Basel, Switzerland)
|May 24, 2020
Summary
Strongyloidiasis affects 5.1% of HIV-infected migrants. Universal screening is recommended, as many co-infected individuals are asymptomatic and lack eosinophilia, a key indicator.
Area of Science:
- Tropical Medicine
- Infectious Diseases
- Public Health
Background:
- Strongyloides stercoralis is a nematode prevalent in tropical and subtropical regions.
- It can cause severe illness, particularly in immunocompromised individuals such as those with HIV.
- High HIV prevalence often overlaps with S. stercoralis endemic areas, increasing co-infection risk.
Purpose of the Study:
- To determine the prevalence of Strongyloides co-infection in HIV-infected migrants.
- To identify clinical and laboratory features associated with strongyloidiasis in this population.
- To evaluate the utility of eosinophilia as a diagnostic marker for co-infection.
Main Methods:
- Retrospective study analyzing serological testing for S. stercoralis in HIV-infected migrants.
- Data collected from patients at the Institute of Tropical Medicine, Antwerp, Belgium.
- Epidemiological, clinical, and laboratory data were extracted from electronic medical records.
Main Results:
- 5.1% of HIV-infected migrants (36 out of 723) were diagnosed with Strongyloides co-infection.
- Eosinophilia (elevated eosinophil count) was present in 53% of co-infected patients and strongly correlated with infection (OR 10.74).
- A significant proportion (22%) of co-infected patients were asymptomatic and lacked eosinophilia.
Conclusions:
- Strongyloidiasis is a notable co-infection in HIV-infected migrants, with a 5.1% prevalence.
- While eosinophilia is a strong indicator, its absence does not rule out infection.
- Universal screening for Strongyloides is recommended for all HIV-positive patients originating from tropical regions.
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