Estudo epidemiológico e imunológico da associação entre Strongyloides stercoralis e HTLV-I

Considerable evidence has recently been accumulated concerning complication of strongyloidiasis such as recurrence and severe disease in patients with HTLV-1 infection. The main objectives of the present study were: 1) to determine the prevalence of S. stercoralis infection in blood donnors infected or not with HTLV-1, 2) to compare the IgG and IgE serologycal tests for S. stercoralis antigens, as well as the immediate hipersensibility skin test in patients coinfected with HTLV-1 and S. stercoralis, with those having only strongyloidiasis, and 3) to determine how HTLV-1 infection may change the pattern of cytokines secreted by mononuclear cells from patients with strongyloidiasis. The frequency of S stercoralis infection was twice higher in subjects coinfected with HTLV-1 than in blood donnors with only HTLV-1 (p = 0.128) and four fold higher than that observed in patients from the Hospital Universitario Prof Edgard Santos (p = 0.01), While specific IgG levels anti S. stercoralis were similar in patients with strongyloidiasis when compared with subjects coinfected with HTLV-1 and S. stercoralis (p = 0.54), the mean IgE levels in this later group was lower (74 ± 94IU) than that observed in patients with only strongyloidiasis (251 ± 473IU), (p = 0.01). The size of the skin test enduration was also larger in patients with strongyloidiasis (136 ± 75mm^), when compared with subjects coinfected with S. stercoralis and HTLV-1(74 ± 65mm^), (p = 0.001). Additionaly the positivity of the IgE test and of the immediate hipersensitivity skin test was significantly lower (p = 0.004 and p = 0 002 respectively) in the group coinfected when compared with patients who had only strongyloidiasis. In patients coinfected, the IPN-y and IL-5 levels were 919 ± 944 and 173 ± 168 pg/ml respectively, while in subjects with only strongyloidiasis the levels of these citokines were 20 ± 46 and 727 ± 554 pg/ml (p = 0.01 and p < 0.0001 respectively). These data show that HTLV-1 infection leads to a decreasing in the IgE level and, skin test reactivity, in patients coinfected with S. stercoralis and also reduce significantly the levels of BL-5.