Immunofluorescence assay for diagnosis of strongyloidiasis in immunocompromised patients

Abstract

Background: Strongyloides stercoralis is a parasite that causes human strongyloidiasis. The disease ranges from asymptomatic to severe forms, which are often fatal in immunocompromised individuals. Laboratory diagnosis is challenging owing to limitations in the use of conventional parasitological techniques. The present study aimed to evaluate the indirect immunofluorescence assay (IFA) using infective larvae of S. venezuelensis as an antigen for the immunodiagnosis of human strongyloidiasis in immunocompromised patients. Methods: Serum and stool samples from 200 immunocompromised patients (HIV-positive, HTLV-1-positive, and renal, liver, and/or bone marrow transplantation candidates) were used. Stool samples were examined using three parasitological methods: Lutz, Rugai, and culture agar plate. IFA was performed using sections of infective larvae of S. venezuelensis as antigens, and showed 95.4% sensitivity and 95.8% and specificity. Results: Among the 200 patients, 17 (8.5%) were positive for S. stercoralis by at least one parasitological method, and 43 (21.5%) were positive by IFA. Conclusions: IFA can be used as a screening method for the detection of S. stercoralis in immunocompromised patients.

Keywords::

• Strongyloides stercoralis
• immunosuppression
• immunodiagnosis
• indirect immunofluorescence antibody

Declaration of interest: This research was supported by Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP 2010/51110-2), Brazil. The authors report no conflicts of interest.