What are the risk factors for severe strongyloidiasis?

Updated: Jun 20, 2019
  • Author: Pranatharthi Haran Chandrasekar, MBBS, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Risk factors for severe strongyloidiasis include the following:

  • Corticosteroid therapy: This is the most important risk factor [5, 7] ; other immunosuppressive agents are also risk factors (eg, chemotherapeutic agents, tacrolimus, tumor necrosis factor [TNF] modulators)

  • Human T-cell leukemia virus type 1 (HTLV-1) infection [8, 9] : HTLV-1, the retrovirus associated with adult T-cell leukemia, has a bidirectional relationship with Strongyloides; coinfection with Strongyloides shortens the preleukemic phase of HTLV-1 infection [10] ; the Strongyloides antigen accelerates leukemogenesis, and treatment of the infection may actually decrease HTLV-1 viral load

  • Hypogammaglobulinemia

  • Malignancy/neoplasms, particularly hematologic malignancies (lymphoma, leukemia): Studies have suggested that Strongyloides infection may be associated with increased incidence of gastrointestinal lymphoma [12]

  • Organ transplantation [13, 14, 15, 16]

  • Malabsorption states and malnutrition

  • Chronic renal failure and end-stage renal disease

  • Diabetes mellitus

  • Advanced age

  • Collagen-vascular disease

  • Chronic alcohol consumption [3]

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