Persistence of Babesia microti Infection in Humans.

Evan M Bloch,Peter J Krause,Sanjai Kumar

doi:10.3390/pathogens8030102

Abstract

Persistent infection is a characteristic feature of babesiosis, a worldwide, emerging tick-borne disease caused by members of the genus Babesia. Persistence of Babesia infection in reservoir hosts increases the probability of survival and transmission of these pathogens. Laboratory tools to detect Babesia in red blood cells include microscopic detection using peripheral blood smears, nucleic acid detection (polymerase chain reaction and transcription mediated amplification), antigen detection, and antibody detection. Babesia microti, the major cause of human babesiosis, can asymptomatically infect immunocompetent individuals for up to two years. Chronically infected blood donors may transmit the pathogen to another person through blood transfusion. Transfusion-transmitted babesiosis causes severe complications and death in about a fifth of cases. Immunocompromised patients, including those with asplenia, HIV/AIDS, malignancy, or on immunosuppressive drugs, often experience severe disease that may relapse up to two years later despite anti-Babesia therapy. Persistent Babesia infection is promoted by Babesia immune evasive strategies and impaired host immune mechanisms. The health burden of persistent and recrudescent babesiosis can be minimized by development of novel therapeutic measures, such as new anti-parasitic drugs or drug combinations, improved anti-parasitic drug duration strategies, or immunoglobulin preparations; and novel preventive approaches, including early detection methods, tick-avoidance, and blood donor screening.

Highlights

Babesia are intraerythrocytic protozoa in the same Apicomplexa phylum as Plasmodia
The health burden of persistent and recrudescent babesiosis can be minimized by development of novel therapeutic measures, such as new anti-parasitic drugs or drug combinations, improved anti-parasitic drug duration strategies, or immunoglobulin preparations; and novel preventive approaches, including early detection methods, tick-avoidance, and blood donor screening
It causes a malaria-like illness that is fatal in about 20% of immunocompromised hosts and those who acquire the infection through blood transfusion

Summary

Introduction

Babesia are intraerythrocytic protozoa in the same Apicomplexa phylum as Plasmodia. They are transmitted worldwide by hard-bodied ticks and infect a wide variety of wild and domestic animals. Persistent infection is a characteristic feature of babesiosis and malaria, the two primary intraerythrocytic protozoal diseases of humans [5,6,7,8,9]. Both depend on an arthropod vector to transmit infection from other humans (Plasmodia) or animal hosts (Babesia). P.impervious vivax to sequester cells during the and hypnozoite within cellspaper, duringwe thewill hypnozoite of the life cycle In this focus on stage persistence of B. microti infection, focus on persistence of B. microti the most commonlaboratory cause of babesiosis humans.

Babesia

Persistent

Mechanisms of Babesia Persistence

Findings

Conclusions