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Treatment of W. bancrofti (Wb) in HIV/Wb coinfections in South India.

Talaat KR, Babu S, Menon P, Kumarasamy N, Sharma J, Arumugam J, Dhakshinamurthy K, Srinivasan R, Poongulali S, Gu W, Fay MP, Swaminathan S, Nutman TB - PLoS Negl Trop Dis (2015)

Bottom Line: Following treatment, no differences were noted in clinical outcomes between the 2 groups.Furthermore, there were no significant differences found in either the change in viral load at 1, 3, or 6 months or in the change in CD4 count at 3, 6, or 12 months between the 2 groups.Treatment of W. bancrofti coinfection in HIV positive subjects (as is usual in mass drug administration campaigns) did not represent an increased risk to the subjects, and should therefore be considered for PLWHA living in W. bancrofti endemic areas.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, United States of America; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.

ABSTRACT

Background: The disease course of human immunodeficiency virus (HIV) is often altered by existing or newly acquired coincident infections.

Methodology/principal findings: To assess the influence of pre-existing Wuchereria bancrofti infection on HIV progression, we performed a case-controlled treatment study of HIV positive individuals with (FIL+) or without (FIL-) W. bancrofti infection. Twenty-eight HIV+/FIL+ and 51 matched HIV+/FIL- subjects were treated with a single dose of diethylcarbamazine and albendazole (DEC/Alb) and followed for a year at regular intervals. Sixteen of the HIV+/FIL+ subjects (54%) and 28 of the HIV+/FIL- controls (57%) were on antiretroviral therapy (ART) during the study. Following treatment, no differences were noted in clinical outcomes between the 2 groups. There also was no significant difference between the groups in the HIV viral load at 12 months as a percentage of baseline viral load (HIV+/FIL+ group had on average 0.97 times the response of the HIV+/FIL- group, 95% CI 0.88, 1.07) between the groups. Furthermore, there were no significant differences found in either the change in viral load at 1, 3, or 6 months or in the change in CD4 count at 3, 6, or 12 months between the 2 groups.

Conclusions/significance: We were unable to find a significant effect of W. bancrofti infection or its treatment on HIV clinical course or surrogate markers of HIV disease progression though we recognized that our study was limited by the smaller than predicted sample size and by the use of ART in half of the patients. Treatment of W. bancrofti coinfection in HIV positive subjects (as is usual in mass drug administration campaigns) did not represent an increased risk to the subjects, and should therefore be considered for PLWHA living in W. bancrofti endemic areas.

Trial registration: ClinicalTrials.gov NCT00344279.

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Related in: MedlinePlus

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pntd.0003622.g001: Consort diagram.

Mentions: 376 subjects were screened (Fig. 1). Twenty-eight subjects were found to be filarial positive (HIV+/FIL+). These were matched with 52 HIV positive subjects who did not have Wb infection (filarial-negative) (HIV+/FIL-) as controls (one control subject had no baseline viral load). Baseline summary statistics are given in Table 1. Because the groups are matched, as expected there are no significant differences between the groups (Table 1, Fig. 2). Many subjects in both groups took co-trimoxazole and a multivitamin throughout the study. Less than 10% of subjects were positive for ova or parasites on stool exam, so this variable was not included in the analyses.


Treatment of W. bancrofti (Wb) in HIV/Wb coinfections in South India.

Talaat KR, Babu S, Menon P, Kumarasamy N, Sharma J, Arumugam J, Dhakshinamurthy K, Srinivasan R, Poongulali S, Gu W, Fay MP, Swaminathan S, Nutman TB - PLoS Negl Trop Dis (2015)

Consort diagram.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4368731&req=5

pntd.0003622.g001: Consort diagram.
Mentions: 376 subjects were screened (Fig. 1). Twenty-eight subjects were found to be filarial positive (HIV+/FIL+). These were matched with 52 HIV positive subjects who did not have Wb infection (filarial-negative) (HIV+/FIL-) as controls (one control subject had no baseline viral load). Baseline summary statistics are given in Table 1. Because the groups are matched, as expected there are no significant differences between the groups (Table 1, Fig. 2). Many subjects in both groups took co-trimoxazole and a multivitamin throughout the study. Less than 10% of subjects were positive for ova or parasites on stool exam, so this variable was not included in the analyses.

Bottom Line: Following treatment, no differences were noted in clinical outcomes between the 2 groups.Furthermore, there were no significant differences found in either the change in viral load at 1, 3, or 6 months or in the change in CD4 count at 3, 6, or 12 months between the 2 groups.Treatment of W. bancrofti coinfection in HIV positive subjects (as is usual in mass drug administration campaigns) did not represent an increased risk to the subjects, and should therefore be considered for PLWHA living in W. bancrofti endemic areas.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, United States of America; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.

ABSTRACT

Background: The disease course of human immunodeficiency virus (HIV) is often altered by existing or newly acquired coincident infections.

Methodology/principal findings: To assess the influence of pre-existing Wuchereria bancrofti infection on HIV progression, we performed a case-controlled treatment study of HIV positive individuals with (FIL+) or without (FIL-) W. bancrofti infection. Twenty-eight HIV+/FIL+ and 51 matched HIV+/FIL- subjects were treated with a single dose of diethylcarbamazine and albendazole (DEC/Alb) and followed for a year at regular intervals. Sixteen of the HIV+/FIL+ subjects (54%) and 28 of the HIV+/FIL- controls (57%) were on antiretroviral therapy (ART) during the study. Following treatment, no differences were noted in clinical outcomes between the 2 groups. There also was no significant difference between the groups in the HIV viral load at 12 months as a percentage of baseline viral load (HIV+/FIL+ group had on average 0.97 times the response of the HIV+/FIL- group, 95% CI 0.88, 1.07) between the groups. Furthermore, there were no significant differences found in either the change in viral load at 1, 3, or 6 months or in the change in CD4 count at 3, 6, or 12 months between the 2 groups.

Conclusions/significance: We were unable to find a significant effect of W. bancrofti infection or its treatment on HIV clinical course or surrogate markers of HIV disease progression though we recognized that our study was limited by the smaller than predicted sample size and by the use of ART in half of the patients. Treatment of W. bancrofti coinfection in HIV positive subjects (as is usual in mass drug administration campaigns) did not represent an increased risk to the subjects, and should therefore be considered for PLWHA living in W. bancrofti endemic areas.

Trial registration: ClinicalTrials.gov NCT00344279.

Show MeSH
Related in: MedlinePlus