Is strongyloidiasis more prevalent in HIV infection?
- Strongyloides stercoralis is an endemic parasite in the subtropical areas worldwide, including the southeastern United States.
- There is no clear evidence that HIV infection predisposes to strongyloidiasis. However, patients with HIV infection may be more prone to develop the Strongyloides hyperinfection syndrome.
- In addition, during therapy with HAART an IRIS with hyperinfection syndrome has been reported.
- Therefore it is important to keep this potentially life-threatening infection in mind when evaluating patients with HIV infection and GI symptoms such as diarrhea, abdominal pain, and dyspepsia.
- In HIV-infected patients with eosinophilia, empiric therapy with ivermectin is warranted while the work-up of eosinophilia is in progress.
- Strongyloides can infect any part of the GI tract.
- However, the classic finding is a “catarrhal” duodenitis, with edema of the villi and massive amounts of yellow exudate covering the mucosa
