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AN INVERSE RELATIONSHIP BETWEEN AUTOIMMUNE LIVER DISEASES AND STRONGYLOIDES STERCORALIS INFECTION

A case-control study was undertaken to describe the prevalence of Strongyloides stercoralis infection among patients with autoimmune liver diseases, such as primary biliary cirrhosis (PBC), autoimmune hepatitis (AIH), and primary sclerosing cholangitis (PSC). This study covered 4,117 patients who were admitted to hospitals in Okinawa, Japan, between 1988 and 2006. During this period, 538 patients had the following chronic liver diseases: PBC, AIH, PSC, chronic viral hepatitis group, and alcoholic liver disease. The other 3,579 patients who were hospitalized and underwent parasitologic tests served as controls. The frequency of S. stercoralis infection in the autoimmune liver diseases group (1.0%) was lower than that found in the control group (7.0%; P = 0.0063). None of the female patients with PBC born before 1955 had S. stercoralis infection, which was also statistically significant (P = 0.045). We hypothesized that immunomodulation by S. stercoralis infection may lower the incidence of autoimmune liver disease.

Received August 23, 2006. Accepted for publication February 12, 2007.

^* Address correspondence to Hajime Aoyama, Control and Prevention of Infectious Diseases, Department of Medicine and Therapeutics, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa. E-mail: haaoyama-gi{at}umin.ac.jp

Authors’ addresses: Hajime Aoyama, Tetsuo Hirata, Takako Watanabe, Satoru Miyagi, Tatsuji Maeshiro, and Jiro Fujita, Control and Prevention of Infectious Diseases, Department of Medicine and Therapeutics, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, Japan. Hiroshi Sakugawa and Tomokuni Nakayoshi, Department of Internal Medicine, Heartlife Hospital, 208 Iju, Nakagusuku, Okinawa, Japan. Mariko Kawane, Takayuki Chinen, and Osamu Zaha, Department of Internal Medicine, Nakagami Hospital, 6-25-5 Chibana, Okinawa city, Okinawa, Japan. Fukunori Kinjo, Department of Endoscopy, Ryukyu University Hospital, 207 Uehara, Nishihara, Okinawa, Japan.

Reprint requests: Hajime Aoyama, Control and Prevention of Infectious Diseases, Department of Medicine and Therapeutics, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, Telephone: 81-98-895-1144, Fax: 81-98-895-1414, E-mail: haaoyama-gi{at}umin.ac.jp.