Utility of PCR in Patients with Strongyloides stercoralis and HTLV-1 Coinfection in French Guiana
Utility of PCR in Patients with Strongyloides stercoralis and HTLV-1 Coinfection in French Guiana
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DOI：
10.4269/ajtmh.19-0082
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发表时间：
2019-01-01
影响因子：
3.3
通讯作者：
Demar, Magalie
中科院分区：
文献类型：
--
作者：
Blaizot, Romain;Simon, Stephane;Demar, Magalie
粪类圆线虫和人类嗜T淋巴细胞病毒1型（HTLV-1）合并感染已在文献中广泛报道，但类圆线虫病的诊断和治疗仍然是一个挑战，特别是在HTLV-1携带者。我们的目的是评估一种新的PCR方法检测S。HTLV-1阳性患者中的粪球菌。粪便收集了超过1年的时间在整个法属圭亚那的流行地区，包括偏远的森林地区。分别以小亚基和特异性重复序列为靶点，比较两种实时荧光PCR方法，并与镜检结果进行比较。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，小亚基PCR法和镜检法的类圆线虫病总患病率分别为30%和11.6%。在血清阳性人群中，所有测试的粪便均为阴性，而51.2%的阳性使用小亚基PCR。因此，PCR允许大大提高灵敏度，特别是在HTLV-1携带者中。在两种检测系统中，小亚单位检测的结果优于特异性重复PCR，HTLV-1携带者的患病率分别为51.2%和22.2%。因此，PCR应被认为是一个有用的工具，用于诊断类圆线虫病，特别是在HTLV-1载体谁往往提出了轻寄生虫负荷，由于不稳定的管理驱虫药。
Strongyloides stercoralis 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 S. stercoralis 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.