Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024, Via Don A Sempreboni 5, Negrar di Valpolicella, Verona, Italy.
Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024, Via Don A Sempreboni 5, Negrar di Valpolicella, Verona, Italy.
Travel Med Infect Dis. 2022 Jul-Aug;48:102324. doi: 10.1016/j.tmaid.2022.102324. Epub 2022 Apr 1.
Screening HIV-positive migrants for neglected tropical diseases having potential for life-threatening reactivation, such as Chagas disease and strongyloidiasis is not widely implemented. We evaluated the prevalence of these infections among a large cohort of HIV-infected migrants from Latin America living in Italy.
Cross-sectional study evaluating the prevalence of Trypanosoma cruzi and Strongyloides stercoralis infections in HIV-infected migrants from Latin America enrolled in the Italian Cohort of Antiretroviral-Naïve patients (ICONA) between 1997 and 2018, based on serology performed on sera stored in the ICONA Foundation biobank. Screening for Chagas disease was performed using two commercial ELISA complemented by commercial Immunoblot and CLIA if discordant. Strongyloidiasis was evaluated using a commercial ELISA.
389 patients were analysed. Fifteen (3.86%) had at least one positive Chagas ELISA test. Prevalence of Chagas disease was 0.5% or 1.29% depending on the confirmatory technique. Serology for strongyloidiasis was positive in 16 (4.11%) patients. Only Nadir CD4 T cell count was associated with discordant serology for Chagas disease (p = 0.046).
The accuracy of seroassays for Chagas disease and strongyloidiasis in HIV-positive patients is unclear. To avoid missing potentially life-threatening infections, we suggest implementing additional diagnostic strategies in at-risk patients with inconclusive serology results.
对 HIV 阳性的移民进行潜在危及生命的再激活的热带病（如恰加斯病和类圆线虫病）筛查并未广泛实施。我们评估了生活在意大利的大量来自拉丁美洲的 HIV 感染移民中这些感染的患病率。
对 1997 年至 2018 年期间参加意大利无抗逆转录病毒治疗的 HIV 感染未感染患者队列（ICONA）的来自拉丁美洲的 HIV 感染移民进行了横断面研究，评估了克氏锥虫和类圆线虫感染的患病率，该研究基于 ICONA 基金会生物库中储存的血清进行了血清学检测。使用两种商业 ELISA 检测进行恰加斯病筛查，并在不一致时使用商业免疫印迹和 CLIA 进行补充。使用商业 ELISA 评估类圆线虫病。
分析了 389 名患者。15 名（3.86%）至少有一种阳性的恰加斯 ELISA 检测结果。恰加斯病的患病率为 0.5%或 1.29%，具体取决于确认技术。16 名（4.11%）患者的类圆线虫病血清学呈阳性。只有 nadir CD4 T 细胞计数与恰加斯病的不一致血清学相关（p=0.046）。
HIV 阳性患者中恰加斯病和类圆线虫病血清学检测的准确性尚不清楚。为避免漏诊潜在危及生命的感染，我们建议对血清学结果不确定的高危患者实施额外的诊断策略。
