{"doi":"10.1371/journal.pntd.0013231","title":"High prevalence of Strongyloides stercoralis in people living with HIV: A critical health challenge in the Peruvian Amazon Basin","abstract":"<h4>Introduction</h4>Strongyloidiasis is an important but underdiagnosed soil-transmitted helminthiasis, particularly in tropical areas and some vulnerable groups.<h4>Objectives</h4>To assess the parasitological prevalence, seroprevalence and sociodemographic factors of Strongyloides stercoralis infection in patients living with human immunodeficiency virus (PLWH) in an endemic area.<h4>Materials and methods</h4>We performed a cross-sectional study of strongyloidiasis in 537 PLWH in two hospitals in Iquitos, Peru, from 20 Oct 2023 to 20 May 2024. We tested patient sera using Strongyloides IgG enzyme-linked immunosorbent assay (ELISA) and stool via the modified Baermann technique and/or charcoal fecal culture as highly sensitive parasitological techniques. We used multivariable logistic regression to identify factors associated with S. stercoralis infection.<h4>Results</h4>Among the 339 PLWH whose stool samples were collected, 82 were positive for S. stercoralis (prevalence 24.2%; 95% confidence interval [CI] 20.0-29.1%). Among the 534 PLWH whose serum samples were collected, 227 were positive (seroprevalence: 42.5%; 95% CI 38.1-47.5%). The kappa value for charcoal culture and Baermann technique was 0.69. ELISA showed a sensitivity of 92.6% and a negative predictive value of 96.9%. Significant risk factors for stool positivity included living in a rural (unpaved) area (adjusted OR: 1.86), whereas significant risk factors for both stool and seropositivity included living in a poor house (made of wood/leaves) (adjusted odds ratio (ORs): 2.18 and 2.48, respectively), in the Loreto Regional Hospital catchment area (adjusted ORs: 5.66 and 5.37, respectively), or being infected by hookworms in stool (adjusted ORs: 23.88 and 9.78, respectively). Having a low level of studies was associated with seropositivity (adjusted OR 2.42).<h4>Conclusion</h4>The prevalence of S. stercoralis is high among PLWH in Iquitos, especially among those living in conditions of socioeconomic vulnerability or co-infected with hookworms. The negative predictive value of the S. stercoralis ELISA was high, although this result should be taken with caution in severe immunosuppression.","journal":"PLOS Neglected Tropical Diseases","year":2025,"id":11094,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.0315,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-07-15","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":89634,"name":"Viviana Pinedo-Cancino","orcid":"0000-0003-0035-563X","position":2,"is_corresponding":false},{"id":89635,"name":"Seyer Mego-Campos","orcid":"0000-0001-6358-3272","position":3,"is_corresponding":false},{"id":89636,"name":"Victoria-Ysabel Villacorta-Pezo","orcid":null,"position":4,"is_corresponding":false},{"id":89637,"name":"Jorge Parráguez-de-la-Cruz","orcid":null,"position":5,"is_corresponding":false},{"id":89638,"name":"Eva H. Clark","orcid":"0000-0002-0350-8753","position":6,"is_corresponding":false},{"id":89639,"name":"Esperanza Merino","orcid":"0000-0003-3854-4874","position":7,"is_corresponding":false},{"id":89641,"name":"Martin Casapia-Morales","orcid":"0000-0002-5972-0948","position":9,"is_corresponding":false},{"id":89642,"name":"José-Manuel Ramos-Rincón","orcid":"0000-0002-6501-9867","position":10,"is_corresponding":false},{"id":89632,"name":"Silvia Otero-Rodriguez","orcid":"0000-0002-7801-5072","position":0,"is_corresponding":true}],"reference_count":47,"raw_metadata":null,"created_at":"2026-03-01T18:20:47.508186Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}