Epidemiological and clinical interaction between HTLV‐1 and <i>Strongyloides stercoralis</i>

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<jats:title>SUMMARY</jats:title><jats:p>Strongyloides stercoralis <jats:italic>is the most common human parasitic nematode that is able to complete a life cycle and proliferate within its host. The majority of patients with strongyloidiasis have an asymptomatic infection or mild disease. However, when autoinfection occurs, a high number of infecting larvae can gain access to the bloodstream by penetrating the colonic mucosa leading to a severe hyperinfection and the development of disseminated strongyloidiasis.</jats:italic></jats:p><jats:p> <jats:italic>The human T cell lymphotropic virus type 1 (HTLV‐1) predominantly infects T cells and induces spontaneous lymphocyte proliferation and secretion of high levels of type 1 cytokines.</jats:italic> Strongyloides stercoralis <jats:italic>patients with HTLV‐1 co‐infection have a modified immunological responses against parasite antigens and co‐infection has clinical implications for strongyloidiasis. The high production of IFN‐γ observed in patients co‐infected with HTLV‐1 and</jats:italic> Strongyloides stercoralis <jats:italic>decreases the production of IL‐4, IL‐5, IL‐13 and IgE, molecules that participate in the host defence mechanism against helminths. Moreover, there is a decrease in the efficacy of treatment of</jats:italic> Strongyloides stercoralis <jats:italic>in patients co‐infected with HTLV‐1. Alterations in the immune response against</jats:italic> Strongyloides stercoralis <jats:italic>and the decrease in the efficacy of anti‐parasitic drugs are responsible for the increased prevalence of</jats:italic> Strongyloides stercoralis <jats:italic>among HTLV‐1 infected subjects and make HTLV‐1 infection the most important risk factor for disseminated strongyloidiasis.</jats:italic></jats:p>

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