Chen Fei, Fu Shuhong, Jiang Jia-Fu, Feng Hao, Liu Zhitong, Sun Yi, Li Mianyang
State Key Laboratory of Pathogen and Biosecurity, Academic Military Medical Sciences, Beijing 100071, China.
Department of Clinical Laboratory Medicine, Huadong Hospital affiliated to Fudan University, Shanghai 200040, China.
Heliyon. 2024 Nov 3;10(22):e39960. doi: 10.1016/j.heliyon.2024.e39960. eCollection 2024 Nov 30.
Human babesiosis, caused by several parasites and transmitted by tick bites and other blood-associated containments, has emerged as a major public health threat around the world. In the absence of readily discernible clinical manifestations, the diagnosis of human babesiosis has been contingent upon the identification of parasites through the utilization of detection arrays. Nevertheless, cases of persistent and relapsing babesiosis with low-grade parasitemia have been sporadically observed in patients with and without immunosuppression, prompting a challenge to the reliability of routine clinical laboratory tests and efficient anti-babesial therapy. In such instances, it is essential to implement repeated and prolonged monitoring until complete eradication of the parasites is achieved. This review presents an overview of the epidemiology of persistent and relapsing human babesiosis, current diagnostic techniques, the mechanism of persistent relapse and practical clinical management strategies. In order to respond effectively to the challenge of low-grade parasitemia infection in the aforementioned patients, it is essential to prioritize the development and validation of rapid, sensitive, and cost-effective point-of-care diagnostic techniques, as well as the development of novel pharmaceutical agents and their combinations.
人类巴贝斯虫病由多种寄生虫引起，通过蜱叮咬及其他与血液相关的污染物传播，已成为全球主要的公共卫生威胁。在缺乏易于识别的临床表现的情况下，人类巴贝斯虫病的诊断依赖于通过检测阵列识别寄生虫。然而，在免疫功能正常和免疫抑制的患者中均偶有观察到持续性和复发性巴贝斯虫病伴低度寄生虫血症的病例，这对常规临床实验室检测的可靠性及有效的抗巴贝斯虫治疗提出了挑战。在此类情况下，必须进行反复且长期的监测，直至寄生虫被彻底清除。本综述概述了持续性和复发性人类巴贝斯虫病的流行病学、当前的诊断技术、持续性复发的机制以及实际的临床管理策略。为有效应对上述患者低度寄生虫血症感染的挑战，必须优先开发和验证快速、灵敏且经济高效的即时诊断技术，以及开发新型药物及其组合。
