Astral Codex Ten

strongyloides hyperinfection

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strongyloides hyperinfection

Article

strongyloides hyperinfection is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between November 23, 2021 and February 01, 2023. The archive places it in contexts such as “strongyloides hyperinfection is a rather rare outcome”; “Dr. Avi Bitterman’s theory of Strongyloides hyperinfection”. It most often appears alongside Alexandros Marinos, Carvallo, COVID.

Metadata

  • Category: Concepts
  • Mention count: 2
  • Issue count: 2
  • First seen: November 23, 2021
  • Last seen: February 01, 2023

Appears In

Source Context

Recovered passages from the original issue text. When the raw archive preserved outbound links inside the source passage, they are listed directly under the quote.

Highlights From The Comments On Ivermectin
November 23, 2021 · Original source
The more realistic stance though is that death or worsening due to hyperinfection is a rather rare outcome and doesn't influence numbers significantly. That's why the doctors in those countries went along with a study that would otherwise be unethical. I still don't know where the significance comes from, but it's not strongyloides hyperinfection.
The entire ivermectin advantage in Ravakirti et al comes from 4/50 people dying in the control group compared to 0/50 in the experimental group. If they have 10% strongyloides prevalence and half of infected people who take steroids get a bad reaction, that explains half of the effect. The other half could be coincidence / other worms / I’m underestimating the effect of strongyloidiasis / real positive effects of ivermectin, but I don’t think the effect of strongyloides is obviously of the wrong magnitude to matter here.
"The host innate and adaptive immune response plays a critical role in the maintenance of chronic strongyloidiasis and the prevention of hyperinfection syndrome and dissemination. Similar to other helminth infections, strongyloidiasis elicits a Th-2 lymphocyte predominant immune response with production of cytokines, IgE antibodies, eosinophils, and mast cells which participate in expulsion and killing of the helminth [3, 7, 11]. Strongyloides antigens activate eosinophils via the innate immune response [12]. Activated eosinophils act as antigen presenting cells to stimulate antigen-specific Th-2 cytokine production including IL-4 and IL-5 [8•, 12]. IL-4 induces activated B lymphocytes to class-switch for production of IgE and IgG4 antibodies and additional cytokines (IL-8) attract granulocytes such as neutrophils to aid in larvae killing [7, 11, 12]. IgE production allows for mast cell degranulation and enhances further eosinophil migration [8•]. IL-5 acts as an eosinophil colony stimulating factor promoting further eosinophil growth and activation [8•, 11, 12]. Approximately 75 % of patients with chronic strongyloidiasis have peripheral eosinophilia or elevated total IgE levels [4, 12]. Protective immunity to infective larvae has been found to involve specific Strongyloides antibodies, complement activation and neutrophils in antibody-dependent, cell-mediated cyotoxicity type responses [11]. Patients with severe disease have been shown to have a significant decrease in antibody levels and a decrease in eosinophil level compared to asymptomatic infected individuals, suggesting that both antibodies and granulocytes play a significant role in protection from infection [11]. The sophisticated interaction between strongyloidiasis and the host immune system allows for long-term survival of the pathogen in the host gastrointestinal tract."
Response To Alexandros Contra Me On Ivermectin
February 01, 2023 · Original source
...ted with steroids, steroids prevent the immune system from fighting a common parasitic worm called Strongyloides , and sometimes people getting treated for COVID died of Strongyloides hyperinfection. Ivermectin could prevent these deaths, which would mean fewer deaths in the treatment group than the control group, which would look like ivermectin preventing deaths f...
...ot to completely rule it out. Even if it is true, I probably overestimated how important it was. My original explanation for the effect was Dr. Avi Bitterman’s theory of Strongyloides hyperinfection. Many people in certain tropical regions are infected with the parasitic worm Strongyloides . Usually a person’s immune system keeps this worm under control, and the par...
...rs with different methodologies. Correcting for this, the findings no longer clear a formal bar for statistical significance, and don’t really look significant either. - Strongyloides hyperinfection usually doesn’t kill patients for several weeks. Most of the COVID trials weren’t observing steroid patients for long enough that hyperinfection was likely to be a conce...
...ly doesn’t kill patients for several weeks. Most of the COVID trials weren’t observing steroid patients for long enough that hyperinfection was likely to be a concern. - Strongyloides hyperinfection isn’t subtle: you can sometimes see worm-shaped tracks along the patient’s skin. Not only would you expect the doctors in the studies to have noticed this and mentioned...