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Kawashima A, Yanagawa Y, Shimogawara R, Yagita K, Gatanaga H, Watanabe K. Amebiasis as a sexually transmitted infection: A re-emerging health problem in developed countries. Glob Health Med 2023; 5:319-327. [PMID: 38162428 PMCID: PMC10730925 DOI: 10.35772/ghm.2023.01064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/21/2023] [Accepted: 10/23/2023] [Indexed: 01/03/2024]
Abstract
Amebiasis, which is caused by Entamoeba histolytica (E. histolytica), is the second leading cause of parasite-related death worldwide. It manifests from asymptomatic carriers to severe clinical conditions, like colitis and liver abscesses. Amebiasis is commonly seen in developing countries, where water and food are easily contaminated by feces because of the poor sanitation. However, a recently challenge in many developed countries is the increase in domestic cases of invasive amebiasis as a sexually transmitted infection (STI amebiasis). In contrast to food-/ waterborne transmission of E. histolytica in developing countries, transmission of STI amebiasis occurs directly through human-to-human sexual contact (e.g., men who have sex with men and people who engage in oral-anal sex); in this setting, asymptomatic infected individuals are the main reservoir of E. histolytica. The Development of screening methods for the early diagnosis of asymptomatic E. histolytica infection is the key to epidemiologic control. Moreover, delay in diagnosis of severe cases (e.g., fulminant amebiasis) leads to death even in developed countries. It is also important to increase clinical awareness of domestically transmitted STI amebiasis in the clinical settings. This review considers the changing epidemiology and clinical manifestations of STI amebiasis, and finally discusses the future strategies for the better practice.
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Affiliation(s)
- Akira Kawashima
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
- The Joint Research Center for Human Retrovirus Infection Kumamoto University Campus, Kumamoto, Japan
| | - Yasuaki Yanagawa
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA
| | - Rieko Shimogawara
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kenji Yagita
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hiroyuki Gatanaga
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- The Joint Research Center for Human Retrovirus Infection Kumamoto University Campus, Kumamoto, Japan
| | - Koji Watanabe
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
- The Joint Research Center for Human Retrovirus Infection Kumamoto University Campus, Kumamoto, Japan
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Yanagawa Y, Shimogawara R, Takano M, Aoki T, Mizushima D, Gatanaga H, Kikuchi Y, Oka S, Yagita K, Watanabe K. Identification of asymptomatic Entamoeba histolytica infection by a serological screening test: A cross-sectional study of an HIV-negative men who have sex with men cohort in Japan. PLoS Negl Trop Dis 2022; 16:e0009793. [PMID: 35468146 PMCID: PMC9071119 DOI: 10.1371/journal.pntd.0009793] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 05/05/2022] [Accepted: 04/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background Amebiasis, caused by Entamoeba histolytica, is spreading in developing countries and in many developed countries as a sexually transmitted infection. Here, we evaluated the efficacy of serological screening to identify asymptomatic E. histolytica infection as a potential epidemiological control measure to limit its spread. Methodology/Principal findings This cross-sectional study was carried out between January and March 2021 in an HIV-negative men who have sex with men (MSM) cohort at the National Center for Global Health and Medicine. Serological screening was performed using a commercially available ELISA kit. For seropositive individuals, we performed stool polymerase chain reaction (PCR) to determine current E. histolytica infection. We performed E. histolytica serological screening of 312 participants. None had a history of E. histolytica infection prior to the study. The overall E. histolytica seropositivity was 6.7% (21/312), which was similar to that found by the rapid plasma reagin test (17/312). We identified current infection in 8 of 20 seropositive participants (40.0%) by stool PCR. Conclusions/Significance Our serological screening approach constitutes a potentially practical epidemiological strategy. Active epidemiological surveys, in combination with an effective screening strategy for asymptomatically infected individuals, should be applied to help reduce sexually transmitted E. histolytica infections. Amebiasis, caused by Entamoeba histolytica, is now spreading not only in developing countries, but also in many of developed countries. Unlike the situation in developing countries, transmission occurs directly from one infected person to another via sexual contact, called sexually transmitted E. histolytica infection. Furthermore, most cases of E. histolytica infection are asymptomatic, who can be a reservoir for sexual transmission in the community. Cost-effective epidemiological strategy is urgently needed. Hereby, we performed a serological test for 312 “asymptomatic” HIV-negative men who have sex with men to assess the effective screening method for E. histolytica infection. We identified 21 seropositive samples (6.7% of seropositivity, 21/312), in which relatively high seropositivity to E. histolytica was seen among the participants with positive serology for Treponema pallidum hemagglutination (TPHA) or hepatitis B core antibody (HBcAb). Finally, we identified current infection (asymptomatic E. histolytica infection) in 8 out of 20 stool sampling cases (40.0%) by polymerase chain reaction. Our serological screening assay provides a potentially practical epidemiological strategy. Active epidemiological survey, in combination with the effective screening strategy for asymptomatically infected individuals are considered for the future control of sexually transmitted E. histolytica infection.
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Affiliation(s)
- Yasuaki Yanagawa
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Parasitology, National Institutes of Infectious Diseases, Tokyo, Japan
| | - Rieko Shimogawara
- Department of Parasitology, National Institutes of Infectious Diseases, Tokyo, Japan
| | - Misao Takano
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takahiro Aoki
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Daisuke Mizushima
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Gatanaga
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Yoshimi Kikuchi
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Kenji Yagita
- Department of Parasitology, National Institutes of Infectious Diseases, Tokyo, Japan
| | - Koji Watanabe
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Parasitology, National Institutes of Infectious Diseases, Tokyo, Japan
- * E-mail:
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McNeil CJ, Kirkcaldy RD, Workowski K. Enteric Infections in Men Who Have Sex With Men. Clin Infect Dis 2022; 74:S169-S178. [PMID: 35416972 DOI: 10.1093/cid/ciac061] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Enteric pathogens are often associated with exposure to food, water, animals, and feces from infected individuals. However, in sexual networks of men who have sex with men (MSM), transmission of enteric pathogens may occur during direct or indirect oral-anal contact. METHODS We performed a scoping review of the literature for studies prior to July 2019 with key terms for gastrointestinal syndromes ("proctitis," "enteritis," "proctocolitis"), enteric pathogens or sexually transmitted infections (STIs), and outbreaks using multiple electronic databases. RESULTS We identified 5861 records through database searches, bibliography reviews, and keyword searches, of which 117 references were included in the pathogen-specific reviews. CONCLUSIONS The strength of observational data describing enteric pathogens in MSM and possible sexual transmission of enteric pathogens varies by pathogen; however, a robust body of literature describes the sexual transmission of Campylobacter, Giardia lamblia, and Shigella (particularly antimicrobial-resistant strains) in sexual networks of MSM. Providers are encouraged to consider enteritis or proctocolitis in MSM as possibly having been sexually transmitted and encourage targeted STI testing. Risk/harm reduction and prevention messages should also be incorporated, though there is an acknowledged paucity of evidence with regards to effective strategies. Further research is needed to understand the transmission and prevention of enteric pathogens in MSM.
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Affiliation(s)
- Candice J McNeil
- Department of Internal Medicine, Section on Infectious Diseases, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Robert D Kirkcaldy
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kimberly Workowski
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.,Department of Medicine, Emory University, Atlanta, Georgia
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Kitaoka A, Tanimura K, Yasuda Y, Nishioka K, Hirayama Y, Uemasu K, Iwashima D, Arita S, Kitai T, Hoshi S, Date E, Iizuka N, Takahashi KI. Successful treatment with metronidazole and paromomycin for fulminant amoebic colitis during cytotoxic chemotherapy in a patient with small-cell lung cancer. IDCases 2021; 26:e01337. [PMID: 34840954 PMCID: PMC8605421 DOI: 10.1016/j.idcr.2021.e01337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 11/25/2022] Open
Abstract
We report the case of a 64-year-old man with advanced small-cell lung cancer who developed fulminant amoebic colitis during cytotoxic chemotherapy. During the first cycle of carboplatin/etoposide treatment, febrile neutropenia and grade 4 neutropenia developed. Because diarrhea, abdominal pain, and bloody stool were observed, abdominal computed tomography was performed, showing intussusception, and extensive colectomy and colostomy were performed. Histopathology of the colon revealed gastrointestinal necrosis and perforation due to Entamoeba histolytica infection. Amoebiasis improved after treatment with metronidazole and paromomycin. The second cycle of carboplatin/etoposide with dose reduction was completed, resulting in a partial response to small-cell lung cancer. The results of this case suggest that paromomycin is an additional option for amoebiasis during cytotoxic chemotherapy, and persistent diarrhea during cytotoxic chemotherapy should alert clinicians to consider the development of amoebiasis.
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Affiliation(s)
- Aya Kitaoka
- Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada, Japan
| | - Kazuya Tanimura
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuto Yasuda
- Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada, Japan
| | - Kensuke Nishioka
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yutaka Hirayama
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kiyoshi Uemasu
- Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada, Japan
| | - Daisuke Iwashima
- Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada, Japan
| | - Sou Arita
- Medical economics division, Health insurance bureau, Ministry of Health, Labour and Welfare, Japan
| | - Toshiyuki Kitai
- Department of Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Japan
| | - Susumu Hoshi
- Department of Gastroenterology, Kishiwada City Hospital, Kishiwada, Japan
| | - Emi Date
- Department of Pathology, Kishiwada City Hospital, Kishiwada, Japan
| | - Norishige Iizuka
- Department of Pathology, Kishiwada City Hospital, Kishiwada, Japan
| | - Ken-Ichi Takahashi
- Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada, Japan
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Yanagawa Y, Nagashima M, Gatanaga H, Kikuchi Y, Oka S, Yokoyama K, Shinkai T, Sadamasu K, Watanabe K. Seroprevalence of Entamoeba histolytica at a voluntary counselling and testing centre in Tokyo: a cross-sectional study. BMJ Open 2020; 10:e031605. [PMID: 32102805 PMCID: PMC7044870 DOI: 10.1136/bmjopen-2019-031605] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Amebiasis, which is caused by Entamoeba histolytica, is a re-emerging public health issue owing to sexually transmitted infection (STI) in Japan. However, epidemiological data are quite limited. METHODS To reveal the relative prevalence of sexually transmitted E. histolytica infection to other STIs, we conducted a cross-sectional study at a voluntary counselling and testing (VCT) centre in Tokyo. Seroprevalence of E. histolytica was assessed according to positivity with an ELISA for E. histolytica-specific IgG in serum samples collected from anonymous VCT clients. RESULTS Among 2083 samples, seropositive rate for E. histolytica was 2.64%, which was higher than that for HIV-1 (0.34%, p<0.001) and comparable to that for syphilis (rapid plasma reagin (RPR) 2.11%, p=0.31). Positivity for Chlamydia trachomatis in urine by transcription-mediated amplification (TMA) was 4.59%. Seropositivity for E. histolytica was high among RPR/Treponema pallidum hemagglutination (TPHA)-positive individuals and it was not different between clients with and without other STIs. Both seropositivity of E. histolytica and RPR were high among male clients. The seropositive rate for anti-E. histolytica antibody was positively correlated with age. TMA positivity for urine C. trachomatis was high among female clients and negatively correlated with age. Regression analysis identified that male sex, older age and TPHA-positive results are independent risk factors of E. histolytica seropositivity. CONCLUSIONS Seroprevalence of E. histolytica was 7.9 times higher than that of HIV-1 at a VCT centre in Tokyo, with a tendency to be higher among people at risk for syphilis infection. There is a need for education and specific interventions against this parasite, as a potentially re-emerging pathogen.
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Affiliation(s)
- Yasuaki Yanagawa
- AIDS Clinical Center, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
- Department of Parasitology, National Institute of Infectious Diseases, Shinjuku-ku, Japan
| | - Mami Nagashima
- Department of Microbiology, Tokyo Metropolitan Institute for Public Health, Shinjuku-ku, Japan
| | - Hiroyuki Gatanaga
- AIDS Clinical Center, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Yoshimi Kikuchi
- AIDS Clinical Center, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Keiko Yokoyama
- Department of Microbiology, Tokyo Metropolitan Institute for Public Health, Shinjuku-ku, Japan
| | - Takayuki Shinkai
- Department of Microbiology, Tokyo Metropolitan Institute for Public Health, Shinjuku-ku, Japan
| | - Kenji Sadamasu
- Department of Microbiology, Tokyo Metropolitan Institute for Public Health, Shinjuku-ku, Japan
| | - Koji Watanabe
- AIDS Clinical Center, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
- Department of Parasitology, National Institute of Infectious Diseases, Shinjuku-ku, Japan
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[Amoebosis: May sexual transmission be an underestimated way of contamination?]. Rev Med Interne 2018; 39:586-588. [PMID: 29703611 DOI: 10.1016/j.revmed.2018.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 04/05/2018] [Accepted: 04/05/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Amoebiasis is a cosmopolitan disease and the third most deadly of parasitic diseases. Entamoeba histolytica is the only one to be pathogenic. Its transmission is not only related to the faecal peril but also sexual, with cases described among men who have sex with men. A case of unusual sexual transmission is described in this article, aiming to discuss the impact of these ways of transmitting amoebiasis on patient management. CASE REPORT We describe the case of an amebic liver abscess in a 27-years-old man who did not travel in endemic areas. After patient interrogation, it seems that the contamination mode was sexual, related to a heterosexual relationship with a new female partner 4 months before the diagnosis. HIV and hepatitis B serologies were negative. CONCLUSION The diagnosis of amoebiasis should be suspected in case of dysentery or liver abscess even if there is no history of travel in endemic areas or of sexual intercourse between men.
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Alvarado-Esquivel C, Sanchez-Anguiano LF, Hernandez-Tinoco J, Estrada-Martinez S, Perez-Alamos AR, Ramos-Nevarez A, Cerrillo-Soto SM, Guido-Arreola CA. Entamoeba histolytica Infection in Female Sex Workers: A Matched Case-Control Study in Durango, Mexico. J Clin Med Res 2017; 9:624-629. [PMID: 28611864 PMCID: PMC5458661 DOI: 10.14740/jocmr3065w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2017] [Indexed: 11/17/2022] Open
Abstract
Background Infection with Entamoeba histolytica (E. histolytica) can be potentially transmitted by sexual contact. The seroepidemiology of E. histolytica in female sex workers has not been studied. The aim of the study was to determine whether E. histolytica is associated with the occupation of female sex work. In addition, the correlates of E. histolytica seroprevalence in female sex workers were also investigated. Methods We performed an age- and gender-matched case-control study of 187 female sex workers and 374 women without sex work. Cases and controls were tested for the presence of E. histolytica IgG antibodies using a commercially available enzyme-linked immunoassay. Seroprevalence association with the characteristics of female sex workers was determined by bivariate analysis. Results Anti-E. histolytica IgG antibodies were found in five (2.7%) of 187 female sex workers and in 16 (4.3%) of 374 controls (odds ratios (OR) = 0.61; 95% confidence intervals (CI): 0.22 - 1.70; P = 0.34). Mean optical density of the immunoassay in seropositive cases and controls was 1.35 ± 0.93 and 0.73 ± 0.45, respectively (P = 0.05). Seroprevalence of E. histolytica infection did not vary significantly with age, education, socioeconomic level, or health status of sex workers. Seropositivity to E. histolytica did not correlate with work characteristics such as duration in the occupation, condom use, type of sex, or a history of sexually transmitted diseases, or with behavioral variables such as washing hands before eating, or consumption of untreated water. Conclusions Results indicate that female sex workers do not have an increased risk for E. histolytica infection in Durango City, Mexico. Further studies to determine the risk of infection with E. histolytica by sexual contact should be conducted.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Luis Francisco Sanchez-Anguiano
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Jesus Hernandez-Tinoco
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Sergio Estrada-Martinez
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Alma Rosa Perez-Alamos
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Agar Ramos-Nevarez
- Clinica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Predio Canoas S/N, 34079 Durango, Mexico
| | - Sandra Margarita Cerrillo-Soto
- Clinica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Predio Canoas S/N, 34079 Durango, Mexico
| | - Carlos Alberto Guido-Arreola
- Clinica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Predio Canoas S/N, 34079 Durango, Mexico
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Yanagawa Y, Nagata N, Watanabe K, Tsukada K, Teruya K, Kikuchi Y, Gatanaga H, Akiyama J, Uemura N, Oka S. Increases in Entamoeba histolytica Antibody-Positive Rates in Human Immunodeficiency Virus-Infected and Noninfected Patients in Japan: A 10-Year Hospital-Based Study of 3,514 Patients. Am J Trop Med Hyg 2016; 95:604-609. [PMID: 27296390 PMCID: PMC5014266 DOI: 10.4269/ajtmh.16-0134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 05/05/2016] [Indexed: 11/30/2022] Open
Abstract
Serological evidence of the epidemiological trends in Entamoeba histolytica infection is scarce, especially in nonendemic countries. We aimed to determine the antibody-positive rates over a 10-year period, and compare the trends between human immunodeficiency virus (HIV)–infected and –noninfected patients. We reviewed 3,514 patients who underwent antibody testing during the study periods, which were divided into five annual categories: 2004–2005, 2006–2007, 2008–2009, 2010–2011, and 2012–2013. Anti-E. histolytica antibody was assessed by indirect immunofluorescence assay. The antibody-positive rate increased yearly from 2004–2005 to 2012–2013 (P < 0.001), although there was no increase in the annual number of antibody tests. This trend was seen among males (18.6–28.3%; P < 0.01), females (5.4–28.2%; P < 0.01), HIV-infected patients (18.4–26.9%; P < 0.001), and non-HIV-infected patients (14.6–36.8%; P < 0.001), and HIV-infected men who have sex with men (19.4–29.1%; P < 0.001). Among antibody-positive patients, there was a significant increase in the proportion of patients with high (≥ 1,600) titers (0.7–12.9%; P < 0.001), whereas this trend was not seen in patients with low (100) or intermediate (200–800) titers (P = 0.282 and 0.409, respectively). This large hospital-based study demonstrated that positive anti-E. histolytica antibody rates increased over 10 years, even though the annual number of antibody tests remained constant. Moreover, this trend was identified in non-high-risk patients (females and non-HIV-infected patients) as well as in high-risk patients. The proportion of patients with high antibody titers significantly increased among the antibody-positive patients.
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Affiliation(s)
- Yasuaki Yanagawa
- Center for AIDS Research, Kumamoto University, Kumamoto, Japan.,Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Naoyoshi Nagata
- Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koji Watanabe
- Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Kunihisa Tsukada
- Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Katsuji Teruya
- Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Yoshimi Kikuchi
- Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Hiroyuki Gatanaga
- Center for AIDS Research, Kumamoto University, Kumamoto, Japan.,Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Junichi Akiyama
- Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Naomi Uemura
- Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan
| | - Shinichi Oka
- Center for AIDS Research, Kumamoto University, Kumamoto, Japan.,Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
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Ishikane M, Arima Y, Kanayama A, Takahashi T, Yamagishi T, Yahata Y, Matsui T, Sunagawa T, Nozaki T, Oishi K. Epidemiology of Domestically Acquired Amebiasis in Japan, 2000-2013. Am J Trop Med Hyg 2016; 94:1008-14. [PMID: 26976888 DOI: 10.4269/ajtmh.15-0560] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 01/28/2016] [Indexed: 01/19/2023] Open
Abstract
Notifications of amebiasis have been increasing in Japan. Using national surveillance data during 2000-2013, reported cases of amebiasis were analyzed. A case of amebiasis was defined as laboratory-confirmed Entamoeba histolytica infection, regardless of presence of symptoms. We described temporal trends and analyzed correlates of asymptomatic versus symptomatic cases based on odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression. Of 9,946 cases reported during 2000-2013, 7,403 were domestic cases. During this period, the proportion of domestic cases increased from 63% to 85%. Among male cases, majority were middle aged, and from 2008, the number of cases attributed to heterosexual contact surpassed that of homosexual contact. During 2010-2013, increase in notifications was associated with asymptomatic cases, colonoscopy diagnosis, and males with unknown or heterosexual route of infection. Among males, colonoscopy (OR = 31.5; 95% CI = 14.0-71.0) and cases with unknown route of infection, relative to homosexual contact (OR = 2.2; 95% CI = 1.3-3.9), were associated with asymptomatic infections in multivariate analysis. Although the recent rise may have been due to enhanced detection by colonoscopy or reporting, the large number of asymptomatic cases, with reportedly unknown or heterosexual route of infection, has led to a better understanding of amebiasis in Japan and highlights the potential public health concern.
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Affiliation(s)
- Masahiro Ishikane
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuzo Arima
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Atsuhiro Kanayama
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takuri Takahashi
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takuya Yamagishi
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuichiro Yahata
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tamano Matsui
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomimasa Sunagawa
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomoyoshi Nozaki
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazunori Oishi
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
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Lin CY, Chen TC, Dai CY, Yu ML, Lu PL, Yen JH, Chen YH. Serological investigation to identify risk factors for post-flood infectious diseases: a longitudinal survey among people displaced by Typhoon Morakot in Taiwan. BMJ Open 2015; 5:e007008. [PMID: 25976763 PMCID: PMC4442151 DOI: 10.1136/bmjopen-2014-007008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES After Typhoon Morakot struck Taiwan in 2009, thousands of Taiwanese citizens were displaced to shelters for several weeks. Others were placed in urban communities where they had family members. This study aimed to investigate serological status in both groups and identify risk factors associated with seroconversion of infectious diseases. DESIGN A longitudinal survey. SETTING All experimental and clinical investigations were performed in a tertiary teaching hospital. PARTICIPANTS A total of 288 displaced persons (96 males and 192 females) were recruited and complete follow-up data through two rounds of sampling were collected. The average age was 58.42 years (range 31-87 years). INTERVENTIONS First, serum specimens were collected between December 2009 and January 2010, 4-5 months after the typhoon. The second round of specimen collection was carried out after 6 months. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measured was serological status of vaccine-preventable droplet-borne infectious diseases (ie, measles, mumps, rubella) and water-borne diseases (ie, amoebiasis and leptospirosis). The secondary outcome was identification of risk factors for seroconversion using univariate and multivariate analyses. RESULTS Complete data were available for all 288 displaced persons (114 from the shelter group; 174 from the community group). Seroconversion of Entamoeba histolytica was observed in 128 (44.4%) participants, with a significantly higher rate in the shelter group than in the community group (56.1% vs 36.8%; p=0.001). There were 10 cases of rubella seroconversion. After adjusting for medical history, hypertension and hyperlipidaemia, shelter stay was associated with higher risk for seroconversion (OR=2.055, 95% CI 1.251 to 3.374; p=0.004). Amoebiasis was more evident in the shelter group, although the manifestations were mild. CONCLUSIONS Our results suggested that (1) a clean water supply is essential postdisaster, especially in crowded shelters, and (2) vaccination programmes should be extended to populations at higher risk for post-disaster displacement or to those with weakened immune status.
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Affiliation(s)
- Chun-Yu Lin
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Medicine, Tropical Medicine Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tun-Chieh Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Medicine, Tropical Medicine Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Yen Dai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Liang Lu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Medicine, Tropical Medicine Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jeng-Hsien Yen
- Graduate Institute of Medicine, Tropical Medicine Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Hsu Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Medicine, Tropical Medicine Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Lo YC, Hung CC. Prevalence of HIV infection and risky sexual practices among adult males with travel-associated Entamoeba histolytica infection in Taiwan, 2006-2013. Travel Med Infect Dis 2015; 13:104-5. [PMID: 25593040 DOI: 10.1016/j.tmaid.2014.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 12/27/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Yi-Chun Lo
- Office of Preventive Medicine, Centers for Disease Control, 6 Linsen South Road, Taipei City, 10050, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung Shan South Road, Taipei City, 10002, Taiwan.
| | - Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung Shan South Road, Taipei City, 10002, Taiwan
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Lee KC, Lu CC, Hu WH, Lin SE, Chen HH. Colonoscopic diagnosis of amebiasis: a case series and systematic review. Int J Colorectal Dis 2015; 30:31-41. [PMID: 25346004 DOI: 10.1007/s00384-014-2040-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2014] [Indexed: 02/08/2023]
Abstract
PURPOSE Nonspecific gastrointestinal symptoms make diagnosis of amebiasis difficult. Certain colonoscopic findings predict amebic colitis while others suggest different diagnoses. We aimed to evaluate the diagnostic capability of colonic evaluation of amebiasis. METHODS We retrospectively reviewed data of all amebiasis cases admitted to our institution between 2003 and 2012. Cases were diagnosed by clinical presentation, laboratory examinations, and colonoscopy with biopsy and microscopic examination. Patients were stratified as right-sided colitis and proctosigmoiditis. A systematic review was conducted by searching Medline, Cochrane, EMBASE, and Google Scholar using key words amebiasis, amebic colitis, amebic proctosigmoiditis, colonoscopy, and Entamoeba histolytica. Data were extracted from articles meeting the inclusion criteria. Colonoscopic findings were described and studies were assessed for quality. RESULTS The current series included 20 patients (5 male, 15 female, median age 51), 7 with amebic liver abscess and 13 with amebic colitis. Colonoscopic findings of right-sided colitis included aphthae or erosions, ulcers, exudates, or edematous swollen mucosa in cecum, and findings for proctosigmoiditis were edematous swollen mucosa with bloody exudate. In 25 studies, colonoscopic findings of 41 patients (36 male, 5 female, median age 43.39 years) included mainly ulcers in the cecum and rectum, ulcerated mass, and edematous mucosa; and in fewer patients, submucosal invasion suggestive of colon cancer, bleeding ulcers, proctitis, and ulcers with aphthae in rectum. CONCLUSIONS Colonic evaluation of suspected amebiasis is of diagnostic value when accompanied by biopsy and microscopic identification of Entamoeba species. Colonoscopic manifestations vary between right-sided colitis and proctosigmoiditis.
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Affiliation(s)
- Ko-Chao Lee
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital - Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Chang YH, Liu WC, Chang SY, Wu BR, Wu PY, Tsai MS, Hung CC, Lew-Ting CY. Associated factors with syphilis among human immunodeficiency virus-infected men who have sex with men in Taiwan in the era of combination antiretroviral therapy. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2014; 47:533-41. [DOI: 10.1016/j.jmii.2013.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 09/04/2013] [Accepted: 11/04/2013] [Indexed: 10/25/2022]
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Prevalent and incident HIV diagnoses among Entamoeba histolytica-infected adult males: a changing epidemiology associated with sexual transmission--Taiwan, 2006-2013. PLoS Negl Trop Dis 2014; 8:e3222. [PMID: 25299178 PMCID: PMC4191956 DOI: 10.1371/journal.pntd.0003222] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/26/2014] [Indexed: 11/27/2022] Open
Abstract
Background Sexually transmitted Entamoeba histolytica infection (EHI) has been increasingly recognized among men who have sex with men (MSM). We used the National Disease Surveillance Systems (NDSS) to identify prevalent and incident HIV diagnoses among adults with EHI and to determine the associated factors. Methodology The NDSS collect demographic, clinical, and behavioral characteristics of case patients through physician reports and public health interviews. EHI was confirmed by polymerase-chain-reaction assays, histopathology, or serology with documented liver abscess. We linked NDSS databases to identify prevalent and incident HIV diagnoses among noninstitutionalized Taiwanese adults with confirmed EHI during 2006–2013. Cox proportional-hazards analysis was used to determine associated factors. Principal findings Of noninstitutionalized adults with EHI, we identified prevalent HIV diagnosis in 210 (40%) of 524 males and one (1.7%) of 59 females, and incident HIV diagnosis in 71 (23%) of 314 males. MSM accounted for 183 (87%) and 64 (90%) of prevalent and incident HIV diagnoses in males, respectively. From 2006–2009 to 2010–2013, the prevalence of HIV diagnosis increased from 32% to 45% (P = 0.001) while the incidence of HIV diagnosis increased from 5.4 to 11.3 per 100 person-years (P = 0.001) among males with EHI. Incident HIV diagnosis was independently associated with a younger age, residing in metropolitan areas, hospitalization, previous syphilis, and engagement in oral, anal, or oral–anal sex before illness onset. Conclusions/significance Prevalent and incident HIV diagnoses were increasingly identified among adult males in Taiwan, preferentially affecting younger urban MSM. Surveillance and risk-reduction interventions are recommended against the interplay of HIV epidemic and sexually transmitted EHI. Although sexually transmitted Entamoeba histolytica infection has been increasingly recognized among men who have sex with men (MSM) in Australia, Japan, Korea, and Taiwan, particularly those with HIV infection, no studies have examined E. histolytica infection in relation to HIV and attribution of sexual transmission at a national level. We analyzed the national surveillance data in Taiwan and demonstrated that the prevalent and incident HIV diagnoses increased among E. histolytica-infected adult males from 2006–2009 to 2010–2013, which were associated with previous syphilis and engagement of oral, anal, oral–anal sex. The findings indicate sexual transmission might have replaced traditional risk factors as the major route of E. histolytica transmission among adult males in Taiwan. E. histolytica infection associated with prevalent and incident HIV diagnoses preferentially affects younger urban MSM, suggesting new targets of surveillance and public health interventions for this sexually transmissible protozoan infection.
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Kenyon C, Osbak K. Certain attributes of the sexual ecosystem of high-risk MSM have resulted in an altered microbiome with an enhanced propensity to generate and transmit antibiotic resistance. Med Hypotheses 2014; 83:196-202. [PMID: 24857261 DOI: 10.1016/j.mehy.2014.04.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 04/03/2014] [Accepted: 04/22/2014] [Indexed: 01/30/2023]
Abstract
Surveillance data from a number of countries have indicated that antibiotic resistance in Neisseriagonorrhoea is strongly associated with men who have sex with men (MSM). This manuscript advances the hypothesis that certain features of the MSM sexual ecosystem may be responsible for this association. It is argued that in comparison with heterosexuals, high-risk MSM (hrMSM) have a higher prevalence of oro-penile, oro-rectal and anal sex which facilitates an enhanced mixing of the pharyngeal, rectal and penile microbiomes. In addition, hrMSM have an increased number of sexual partners per unit time and an increased prevalence of sexual relationships overlapping in time. The increased flux of microbiomes between different body habitats between sexual partners, in combination with the increased connectivity of the sexual network, serve to create a novel high-risk MSM sexual ecosystem with important consequences for the genesis and spread of antibiotic resistance.
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Affiliation(s)
- C Kenyon
- HIV/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium.
| | - K Osbak
- HIV/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium
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Watanabe K, Aoki T, Nagata N, Tanuma J, Kikuchi Y, Oka S, Gatanaga H. Clinical Significance of High Anti-Entamoeba histolytica Antibody Titer in Asymptomatic HIV-1-infected Individuals. J Infect Dis 2013; 209:1801-7. [DOI: 10.1093/infdis/jit815] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Seroprevalence of Entamoeba histolytica infection among Chinese men who have sex with men. PLoS Negl Trop Dis 2013; 7:e2232. [PMID: 23717699 PMCID: PMC3662687 DOI: 10.1371/journal.pntd.0002232] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 04/11/2013] [Indexed: 11/19/2022] Open
Abstract
Background Men who have sex with men (MSM) were found to be one of the high-risk populations for Entamoeba histolytica (E. histolytica) infection. Accompanied by the prevalence of human immunodeficiency virus (HIV) among MSM, invasive amebiasis caused by E. histolytica has been paid attention to as an opportunistic parasitic infection. However, the status of E. histolytica infection among MSM has been barely studied in mainland China. Methods Seroprevalance of E. histolytica was determined using an enzyme-linked immunosorbent assay based on a cross-sectional study conducted in Beijing and Tianjin, China. Factors potentially associated with E. histolytica infection were identified by logistic regression analysis. Results A total of 602 MSM were included in the study and the laboratory data on serostatus of E. histolytica were available for 599 of them (99.5%). 246 (41.1%) and 51 (8.5%) of the study participants were E. histolytica seropositive and HIV seropositive, respectively. Univariate analyses suggested preferred anal sex behaviors were associated with E. histolytica seropositivity. In multivariate logistic regression analysis, “only has receptive anal sex” (OR: 2.03; 95% CI: 1.22 3.37), “majority receptive anal sex” (OR: 1.83; 95% CI: 1.13, 2.95), and “sadomasochistic behavior (SM)” (OR: 2.30; 95% CI: 1.04, 5.13) were found to be significantly associated with E. histolytica infection. Conclusions High seroprevalence of E. histolytica infection was observed among MSM from Beijing and Tianjin, China. Receptive anal sex behavior and SM were identified as potential predictors. Therefore, E. histolytica and HIV co-infection needs to be concerned among MSM due to their sharing the common risk behaviors. Entamoeba histolytica (E. histolytica) is a very common human gastrointestinal parasitic disease which affects 50 million people worldwide. Men who have sex with men (MSM) have already been found to be one of the high-risk populations with E. histolytica infection. Previous studies have reported an increased risk for E. histolytica infection and invasive amebiasis in HIV seropositive MSM. This pilot study aimed to investigate the serology of E. histolytica among MSM from mainland China. High prevalence of E. histolytica infection (41.1%, 246/599) was observed among the study population, receptive anal sex behavior and sadomasochistic behavior were found to be associated with the E. histolytica serostatus. Although HIV infection was not found to be associated with E. histolytica infection in this pilot study, studies from other countries had reported increased risks for E. histolytica infection and invasive amebiasis among HIV-positive MSM. Our findings suggest E. histolytica infection control needs to be concerned with respect to the increasing HIV prevalence among Chinese MSM population.
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Hung CC, Chang SY, Ji DD. Entamoeba histolytica infection in men who have sex with men. THE LANCET. INFECTIOUS DISEASES 2012; 12:729-36. [PMID: 22917103 DOI: 10.1016/s1473-3099(12)70147-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Entamoeba histolytica infection (amoebiasis) is the second leading cause of death from parasitic diseases. Epidemiological studies from developed countries have reported an increasing prevalence of amoebiasis and of invasive infections, such as amoebic colitis, among men who have sex with men (MSM) who engage in oral-anal sex. Although most infections with E histolytica are asymptomatic, clinical manifestations of invasive amoebiasis mainly include amoebic colitis and amoebic liver abscess, which are associated with substantial morbidity and medical cost. Laboratory diagnosis of amoebiasis should be based on detection of E histolytica by use of tests with high sensitivity and specificity, such as specific amoebic-antigen or PCR-based assays. Microscopy used in routine clinical laboratories is not sensitive or specific enough for detection of E histolytica. Metronidazole or tinidazole remains the mainstay of treatment for invasive amoebiasis, followed by treatment with luminal agents to prevent relapse and transmission of E histolytica to sexual partners or close contacts.
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Affiliation(s)
- Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
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Slavik T. Human immunodeficiency virus-related gastrointestinal pathology: a southern Africa perspective with review of the literature (part 1: infections). Arch Pathol Lab Med 2012; 136:305-15. [PMID: 22372907 DOI: 10.5858/arpa.2011-0332-ra] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Human immunodeficiency virus infection is rife in sub-Saharan Africa and in southern Africa in particular. Despite the increasing availability of antiretroviral therapy in this region, opportunistic infections remain common and frequently involve the gastrointestinal tract. OBJECTIVE To review the histopathologic findings and distinguishing features of human immunodeficiency virus-associated gastrointestinal infections in southern Africa and relate those findings to the documented international literature. DATA SOURCES The available literature on this topic was reviewed and supplemented with personal experience in a private histopathology practice in South Africa. CONCLUSIONS In southern Africa, the range of gastrointestinal, opportunistic infectious pathology in human immunodeficiency virus afflicted patients is diverse and includes viral, bacterial, fungal, and parasitic infections. This infectious pathology is sometimes a manifestation of systemic disease. In profoundly immunocompromised patients, unusual histologic features, involvement of uncommon gastrointestinal tract sites, and more than one pathogen may be seen.
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Affiliation(s)
- Tomas Slavik
- Ampath Pathology Laboratories, University of Pretoria, South Africa.
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Hung CC, Chang SY, Ji DD. Amebiasis deaths in the United States. Am J Trop Med Hyg 2012; 86. [PMID: 22556095 PMCID: PMC3335701 DOI: 10.4269/ajtmh.2012.12-0121a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Tseng YT, Sun HY, Chang SY, Wu CH, Liu WC, Wu PY, Lu CL, Hsieh CY, Hung CC. Seroprevalence of hepatitis virus infection in men who have sex with men aged 18-40 years in Taiwan. J Formos Med Assoc 2012; 111:431-8. [PMID: 22939661 DOI: 10.1016/j.jfma.2011.06.022] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 05/31/2011] [Accepted: 06/02/2011] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND/PURPOSE Men who have sex with men (MSM) are at increased risk for hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections than the general population. Comparisons of the seroprevalence rates of these hepatitis viruses between HIV-positive and HIV-negative MSM are rarely performed in Taiwan. METHODS Between January 2009 and June 2010, data on the serologies for HAV, HBV, and HCV were collected from two groups of patients: HIV-negative MSM, aged 18-40 years, who sought voluntary counseling and testing (VCT) for HIV infection, and HIV-positive MSM of the same age group who sought HIV care at the National Taiwan University Hospital. Both groups of patients were also tested for syphilis. RESULTS During the 18-month study period, 690 HIV-negative MSM and 438 HIV-positive MSM were enrolled and tested for anti-HAV antibody, HBV surface antigen (HBsAg), hepatitis B core antibody (anti-HBc antibody), and anti-HCV antibody. HIV-positive MSM were older than HIV-negative MSM (30.5 ± 5.4 vs. 25.8 ± 4.7 years, p < 0.01). For HIV-positive MSM, the mean CD4 lymphocyte count was 477.6 ± 230.0 cells/μL and 46% of them had undetectable plasma HIV RNA load (< 40 copies/mL by reverse transcription-polymerase chain reaction assay). The overall seroprevalence rates of HAV, HBsAg, and HCV in HIV-positive MSM were 15.1%, 16.4%, and 5.5%, respectively, while in HIV-negative MSM, they were 7.4%, 6.2%, and 0.4%, respectively. In the multivariate analysis, age was significantly associated with seropositivity for HAV (OR [per one age group increase]: 1.96; 95% CI: 1.6-2.5), HBsAg (OR: 2.02; 95% CI: 1.6-2.6), anti-HBc (OR: 2.68; 95% CI: 2.3-3.2), anti-HCV (OR: 1.67; 95% CI: 1.0-2.7), and anti-HBs (OR: 1.25; 95% CI: 1.0-1.5). HIV infection was associated with seropositivity for HBsAg (OR: 1.73; 95% CI: 1.1-2.7), anti-HBc (OR: 2.44; 95% CI: 1.8-3.3), HCV (OR: 8.91; 95% CI: 2.5-31.4), and syphilis (OR: 11.21; 95% CI: 6.7-18.9). CONCLUSION HIV-positive MSM have a higher seroprevalence rate of HBV and HCV infection than HIV-negative MSM in Taiwan. Vaccination and safe-sex counseling should be provided to prevent the transmission of hepatitis viruses among MSM who may be engaged in high-risk behaviors.
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Affiliation(s)
- Yu-Tzu Tseng
- Department of Traumatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Samanta S, Mehra S, Maiti TK, Ghosh P, Ghosh SK. Socio-demographic correlates influencing the trend of intestinal parasitic infestation in a rural community of West Bengal, India. J Public Health (Oxf) 2011. [DOI: 10.1007/s10389-011-0478-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Nissapatorn V, Sawangjaroen N. Parasitic infections in HIV infected individuals: diagnostic & therapeutic challenges. Indian J Med Res 2011; 134:878-97. [PMID: 22310820 PMCID: PMC3284096 DOI: 10.4103/0971-5916.92633] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Indexed: 12/30/2022] Open
Abstract
After 30 years of the human immunodeficiency virus (HIV) epidemic, parasites have been one of the most common opportunistic infections (OIs) and one of the most frequent causes of morbidity and mortality associated with HIV-infected patients. Due to severe immunosuppression, enteric parasitic pathogens in general are emerging and are OIs capable of causing diarrhoeal disease associated with HIV. Of these, Cryptosporidium parvum and Isospora belli are the two most common intestinal protozoan parasites and pose a public health problem in acquired immunodeficiency syndrome (AIDS) patients. These are the only two enteric protozoan parasites that remain in the case definition of AIDS till today. Leishmaniasis, strongyloidiasis and toxoplasmosis are the three main opportunistic causes of systemic involvements reported in HIV-infected patients. Of these, toxoplasmosis is the most important parasitic infection associated with the central nervous system. Due to its complexity in nature, toxoplasmosis is the only parasitic disease capable of not only causing focal but also disseminated forms and it has been included in AIDS-defining illnesses (ADI) ever since. With the introduction of highly active anti-retroviral therapy (HAART), cryptosporidiosis, leishmaniasis, schistosomiasis, strongyloidiasis, and toxoplasmosis are among parasitic diseases reported in association with immune reconstitution inflammatory syndrome (IRIS). This review addresses various aspects of parasitic infections in term of clinical, diagnostic and therapeutic challenges associated with HIV-infection.
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Affiliation(s)
- Veeranoot Nissapatorn
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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