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