Alveolar echinococcosis in immunocompromised hosts.

Humans Echinococcosis, Hepatic / epidemiology HIV Infections Retrospective Studies Immunocompromised Host
Alveolar echinococcosis Cancer Echinococcus multilocularis HIV Immunosuppressive therapy Malignant haemopathy Primary immune deficiency Transplantation

Journal

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420

Informations de publication

Date de publication:
May 2023
Historique:
received: 12 09 2022
revised: 02 12 2022
accepted: 06 12 2022
medline: 28 4 2023
pubmed: 18 12 2022
entrez: 17 12 2022
Statut: ppublish

Résumé

Alveolar echinococcosis (AE) results of an infection with the larval stage of Echinococcus multilocularis. It has been increasingly described in individuals with impaired immune responsiveness. This narrative review aims at describing the presentation of AE according to the type of immune impairment, based on retrospective cohorts and case reports. Implications for patient management and future research are proposed accordingly. Targeted search was conducted in PubMed using ((alveolar echinococcosis) OR (multilocularis)) AND ((immunosuppressive) OR (immunodeficiency) OR (AIDS) OR (solid organ transplant) OR (autoimmunity) OR (immune deficiency)). Only publications in English were considered. Seventeen publications were found, including 13 reports of 55 AE in immunocompromised patients (AE/IS) and 4 retrospective studies of 755 AE immunocompetent patients and 115 AE/IS (13%). The cohorts included 9 (1%) solid organ transplantation (SOT) recipients, 2 (0.2%) HIV patients, 41 (4.7%) with chronic inflammatory/autoimmune diseases (I/AID) and 72 (8.3%) with malignancies. SOT, I/AID and malignancies, but not HIV infection, were significantly associated with AE (odds ratios of 10.8, 1.6, 5.9, and 1.3, respectively). Compared to AE immunocompetent patients, AE/IS was associated with earlier diagnosis (PNM stages I-II: 49/85 (58%) vs. 137/348 (39%), p < 0.001), high rate of atypical imaging (24/50 (48%) vs. 106/375 (28%), p < 0.01), and low sensitivity of serology (19/77 (25%) vs. 265/329 (81%), p < 0.001). Unusually extensive or disseminated infections were described in SOT and I/AID patients. Patients who live in endemic areas should benefit from serology before onset of a long-term immunosuppressive therapy, even if the cost-benefit ratio has to be evaluated. Physicians should explain AE to immunocompromised patients and think about AE when finding a liver lesion. Further research should address gaps in knowledge of AE/IS. Especially, extensive and accurate records of AE cases have to be collected by multinational registries.

Sections du résumé

BACKGROUND BACKGROUND
Alveolar echinococcosis (AE) results of an infection with the larval stage of Echinococcus multilocularis. It has been increasingly described in individuals with impaired immune responsiveness.
OBJECTIVES OBJECTIVE
This narrative review aims at describing the presentation of AE according to the type of immune impairment, based on retrospective cohorts and case reports. Implications for patient management and future research are proposed accordingly.
SOURCES METHODS
Targeted search was conducted in PubMed using ((alveolar echinococcosis) OR (multilocularis)) AND ((immunosuppressive) OR (immunodeficiency) OR (AIDS) OR (solid organ transplant) OR (autoimmunity) OR (immune deficiency)). Only publications in English were considered.
CONTENT BACKGROUND
Seventeen publications were found, including 13 reports of 55 AE in immunocompromised patients (AE/IS) and 4 retrospective studies of 755 AE immunocompetent patients and 115 AE/IS (13%). The cohorts included 9 (1%) solid organ transplantation (SOT) recipients, 2 (0.2%) HIV patients, 41 (4.7%) with chronic inflammatory/autoimmune diseases (I/AID) and 72 (8.3%) with malignancies. SOT, I/AID and malignancies, but not HIV infection, were significantly associated with AE (odds ratios of 10.8, 1.6, 5.9, and 1.3, respectively). Compared to AE immunocompetent patients, AE/IS was associated with earlier diagnosis (PNM stages I-II: 49/85 (58%) vs. 137/348 (39%), p < 0.001), high rate of atypical imaging (24/50 (48%) vs. 106/375 (28%), p < 0.01), and low sensitivity of serology (19/77 (25%) vs. 265/329 (81%), p < 0.001). Unusually extensive or disseminated infections were described in SOT and I/AID patients.
IMPLICATIONS CONCLUSIONS
Patients who live in endemic areas should benefit from serology before onset of a long-term immunosuppressive therapy, even if the cost-benefit ratio has to be evaluated. Physicians should explain AE to immunocompromised patients and think about AE when finding a liver lesion. Further research should address gaps in knowledge of AE/IS. Especially, extensive and accurate records of AE cases have to be collected by multinational registries.

Identifiants

DOI: 10.1016/j.cmi.2022.12.010 PMID: 36528295
pubmed: 36528295
pii: S1198-743X(22)00630-9
doi: 10.1016/j.cmi.2022.12.010
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

593-599

Informations de copyright

Copyright © 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Auteurs

Brice Autier (B)

Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Rennes, France. Electronic address: brice.autier@univ-rennes1.fr.

Bruno Gottstein (B)

Institute of Infectious Diseases, Faculty of Medicine, University of Bern, CH-3012, Bern, Switzerland.

Laurence Millon (L)

Department of Parasitology-Mycology, National Reference Centre for Echinococcoses, University Hospital of Besançon, France; UMR CNRS 6249 Laboratoire Chrono-environnement, Université Bourgogne-Franche-Comté, Besançon, France; European Study Group of Clinical Parasitology, ESCMID, Basel, Switzerland.

Michael Ramharter (M)

European Study Group of Clinical Parasitology, ESCMID, Basel, Switzerland; Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Dept. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Beate Gruener (B)

Division of Infectious Diseases, Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany.

Solange Bresson-Hadni (S)

Department of Parasitology-Mycology, National Reference Centre for Echinococcoses, University Hospital of Besançon, France; Division of Tropical and Humanitarian Medicine and Gastroenterology and Hepatology Unit, Faculty of Medicine, University Hospitals of Geneva, Switzerland.

Sarah Dion (S)

Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France.

Florence Robert-Gangneux (F)

Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Rennes, France; European Study Group of Clinical Parasitology, ESCMID, Basel, Switzerland.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Alveolar echinococcosis in immunocompromised hosts.
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › Parasitoses hépatiques › Échinococcose hépatique › Alveolar echinococcosis in immunocompromised hosts.
questionsmedicales.fr › Maladies du système immunitaire › Déficits immunitaires › Infections à VIH › Alveolar echinococcosis in immunocompromised hosts.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Alveolar echinococcosis in immunocompromised hosts.
questionsmedicales.fr › Phénomènes du système immunitaire › Sujet immunodéprimé › Alveolar echinococcosis in immunocompromised hosts.