EA 3593, Ecosystèmes Amazoniens et Pathologies Tropicales, Université de Guyane, Cayenne, French Guiana.
Service de Dermatologie, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.
Am J Trop Med Hyg. 2019 Oct;101(4):848-850. doi: 10.4269/ajtmh.19-0082.
and human T-lymphotropic virus 1 (HTLV-1) coinfections have been extensively reported in the literature, but the diagnosis and treatment of strongyloidiasis remains a challenge, particularly in HTLV-1 carriers. Our objectives were to evaluate the efficacy of a new PCR method for the detection of in HTLV-1-positive patients. Stools were collected over a 1-year period across the endemic region of French Guiana, including remote forest areas. Two systems of real-time PCR were then used comparatively, with small subunit and specific repeat as respective targets, and compared with the results of microscopic examinations. One-hundred and twelve stool samples were included. Twenty-seven patients (24.1%) presented a positive HTLV-1 serology. The overall prevalence of strongyloidiasis among the 112 patients was 30% with small-subunit PCR and 11.6% with microscopic examinations. In the seropositive population, all tested stools were negative, whereas 51.2% were positive using small-subunit PCR. Thus, PCR allowed a much-improved sensitivity, particularly in HTLV-1 carriers. Among the two systems investigated, small subunit yielded better results than specific repeat PCR, with prevalence rates in HTLV-1 carriers of 51.2% and 22.2%, respectively. Therefore, PCR should be considered as a useful tool for the diagnosis of strongyloidiasis, particularly in HTLV-1 carriers who often present a light parasitic load due to erratic administration of anthelmintic drugs.
并在文献中广泛报道了人类 T 淋巴细胞嗜病毒 1(HTLV-1)的合并感染,但对类圆线虫病的诊断和治疗仍然是一个挑战,尤其是在 HTLV-1 携带者中。我们的目的是评估一种新的聚合酶链反应(PCR)方法在检测 HTLV-1 阳性患者中的效果。在法属圭亚那的流行地区,包括偏远的森林地区,在一年内收集了粪便样本。然后比较了两种实时 PCR 系统,分别以小亚基和特定重复序列为靶标,并与显微镜检查结果进行比较。共纳入 112 份粪便样本。27 例患者(24.1%)呈现阳性 HTLV-1 血清学。112 例患者中类圆线虫病的总流行率为 30%,小亚基 PCR 为 30%,显微镜检查为 11.6%。在血清阳性人群中,所有检测的粪便均为阴性,而小亚基 PCR 有 51.2%为阳性。因此,PCR 显著提高了检测的敏感性,特别是在 HTLV-1 携带者中。在所研究的两种系统中,小亚基的结果优于特异性重复 PCR,HTLV-1 携带者的流行率分别为 51.2%和 22.2%。因此,PCR 应被视为诊断类圆线虫病的有用工具,特别是在 HTLV-1 携带者中,由于驱虫药物不规则使用,寄生虫负荷通常较轻。