Plumelle Y, Edouard A
Service d'hématologie biologique, CHU, Martinique, France.
Rev Med Interne. 1996;17(2):125-9. doi: 10.1016/0248-8663(96)82961-4.
The mechanisms of chronic infestation by Strongyloides stercoralis (Ss) are unknown. Immunodepression is classically evoked to explain the proliferation of the parasite that is sometimes massive and overwhelming. We present here two retrospective studies of 13 cases of strongyloidiasis (three disseminated strongyloidiasis) out of 26 patients with adult T-cell leukemia/lymphoma (ATL) and of ten cases of strongyloidiasis out of 98 patients with AIDS. Ten patients out of 98 were dually infected with both HIV and HTLV-1: 2/10 also infected by Ss. The frequency of Ss infection appears higher in ATL patients when compared with AIDS patients (P < 0.001). Ss-infected ATL patients were younger than those uninfected (P < 0.01). Ss-infected AIDS patients were older than the ones uninfected (p < 0.03). No significative difference was found between ATL and AIDS patients who were over 40 years-old. These data suggest that 1) the particular type of immunodepression produced early by HTLV-1 is more favorable to the development of Ss infection than the one associated with HIV, 2) the latency of expression of HTLV-1, prior to the development of leukemia, is reduced in Ss-infected patients, 3) Ss infection may slow down VIH pathogenic activity.
粪类圆线虫慢性感染的机制尚不清楚。传统上认为免疫抑制是该寄生虫大量增殖的原因，这种增殖有时十分严重且难以控制。我们在此展示两项回顾性研究，一项是对26例成人T细胞白血病/淋巴瘤（ATL）患者中的13例类圆线虫病（3例播散性类圆线虫病）进行的研究，另一项是对98例艾滋病患者中的10例类圆线虫病进行的研究。98例患者中有10例同时感染了HIV和HTLV-1，其中2/10还感染了粪类圆线虫。与艾滋病患者相比，ATL患者中粪类圆线虫感染的频率似乎更高（P < 0.001）。感染粪类圆线虫的ATL患者比未感染的患者更年轻（P < 0.01）。感染粪类圆线虫的艾滋病患者比未感染的患者年龄更大（P < 0.03）。40岁以上的ATL患者和艾滋病患者之间未发现显著差异。这些数据表明：1）HTLV-1早期产生的特殊类型免疫抑制比与HIV相关的免疫抑制更有利于粪类圆线虫感染的发展；2）在感染粪类圆线虫的患者中，白血病发生前HTLV-1表达的潜伏期缩短；3）粪类圆线虫感染可能会减缓HIV的致病活性。
