Lewthwaite Penny, Gill Geoffrey V, Hart C Anthony, Beeching Nicholas J
Infectious Disease Unit, North Manchester General Hospital, Manchester, UK.
Curr Opin Infect Dis. 2005 Oct;18(5):427-35. doi: 10.1097/01.qco.0000182104.40128.18.
Parasites and other infections have many effects on the gastrointestinal tract of individuals who are immunocompromised. Few reviews focus on parasitic infections, which are covered here.
The review first examines recent advances in our understanding of the taxonomy, diagnosis and treatment of pathogens such as cryptosporidia, cyclospora, isospora and microsporidia, which are recognized causes of diarrhoea in the immunocompromised, and discusses possible links between amoebiasis and HIV. The complex interactions of both intact and abnormal immune systems with helminth infections such as hookworm and strongyloidiasis, and with trematode infections such as schistosomiasis, are receiving increasing attention. These are discussed, together with the novel concept of using live helminths to treat inflammatory bowel disease.
Parasitic infections remain a significant problem for immunocompromised individuals in resource-poor settings, and further work is needed to develop accessible diagnostic tests and to improve our understanding and management of their pathogenic effects. New concepts about the interactions of helminths with host immunity suggest the need for collection of further epidemiological and clinical data to unravel the complexities of such immunological interactions.
寄生虫及其他感染对免疫功能低下个体的胃肠道有诸多影响。很少有综述聚焦于寄生虫感染，本文将对此进行阐述。
本综述首先探讨了我们在隐孢子虫、环孢子虫、等孢子虫和微孢子虫等病原体的分类学、诊断和治疗方面的最新进展，这些病原体是免疫功能低下者腹泻的公认病因，并讨论了阿米巴病与艾滋病病毒之间可能存在的联系。完整和异常免疫系统与钩虫和粪类圆线虫等蠕虫感染以及血吸虫病等吸虫感染之间的复杂相互作用正受到越来越多的关注。本文将对这些内容进行讨论，并介绍利用活蠕虫治疗炎症性肠病的新概念。
在资源匮乏地区，寄生虫感染仍是免疫功能低下个体面临的重大问题，需要进一步开展工作，以开发便捷的诊断检测方法，并增进我们对其致病作用的理解和管理。关于蠕虫与宿主免疫相互作用的新概念表明，有必要收集更多的流行病学和临床数据，以阐明此类免疫相互作用的复杂性。
