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Effect of Diethylcarbamazine on HIV Load, CD4%, and CD4/CD8 Ratio in HIV-Infected Adult Tanzanians with or without Lymphatic Filariasis: Randomized Double-Blind and Placebo-Controlled Cross-Over Trial

We assessed the effect of anti-filarial treatment (diethylcarbamazine, DEC) on HIV load, CD4%, and CD4/CD8 ratio in HIV-positive individuals with and without infection with the filarial parasite Wuchereria bancrofti in a randomized, double-blind, placebo-controlled cross-over trial. The study was conducted in Tanga Region, Tanzania, in 2002 and involved 27 adults. A significant decrease in HIV load (54%) and an insignificant increase in CD4% were observed in the HIV-positive individuals with filarial co-infection at 12 weeks after treatment. HIV load and CD4% both increased, although not statistically significantly, in the HIV-positive individuals without filarial infection. The findings suggest that DEC affected HIV load through its effect on the filarial infection rather than through a direct (pharmacodynamic) effect on HIV. Global efforts to control lymphatic filariasis by annual mass treatment with DEC may have a beneficial effect on the HIV/AIDS epidemic in areas where HIV and lymphatic filariasis co-exist.

Received August 16, 2006. Accepted for publication April 18, 2007.

Acknowledgments: The study participants are gratefully acknowledged for their collaboration, and the technical staff at Bombo Research Station (the late Joyce Kivugo, Sudi Hassani, Chille Malimi, Charles Guzo, Zaina Maumba, and Mwanaidi Bagabuje) and DBL—Centre for Health Research and Development (Bente Larsen Jensen and Benedikte Løhr Wilken) are thanked for their valuable assistance throughout the study. We are grateful to the Tanga AIDS Working Group (Firmina S. Mberesero, Anna Chaze, and Ole Sabaini) for providing professional HIV counseling to the study participants. The National Institute for Medical Research, Dar es Salaam (Mwele Malecela-Lazaro), is thanked for collaboration and support.

Financial support: The research was funded by the Council for Development Research, DBL—Centre for Health Research and Development, the AIDS Foundation, the Wedell–Wedellsborg Foundation, and the Knud Højgaard Foundation, all in Denmark.

Disclaimer: The paper is published with permission of the Director General, National Institute for Medical Research, Tanzania.

^* Address correspondence to Nina O. Nielsen, DBL—Centre for Health Research and Development, Department of Veterinary Pathobiology, Faculty of Life Sciences, University of Copenhagen, Jægersborg Allé 1D, 2920 Charlottenlund, Denmark. E-mail: nnielsen{at}dblnet.dk

Authors’ addresses: Nina O. Nielsen, Paul E. Simonsen, and Pascal Magnussen, DBL—Centre for Health Research and Development, Department of Veterinary Pathobiology, Faculty of Life Sciences, University of Copenhagen, Jægersborg Allé 1D, 2920 Charlottenlund, Denmark, Telephone: +45 77 32 77 32, Fax: +45 77 32 77 33, E-mail: nnielsen{at}dblnet.dk. Peter Dalgaard, Department of Biostatistics, University of Copenhagen, Oester Farimagsgade 5, P.O. Box 2099, 1014 Copenhagen K, Denmark, Telephone: +45 35 32 79 18, Fax: +45 35 32 79 07, E-mail: p. dalgaard{at}biostat.ku.dk. Henrik Krarup, Department of Clinical Biochemistry, Aalborg University Hospital, P.O. Box 561, 9100 Aalborg, Denmark, Telephone: +45 99 32 11 11, Fax: +45–98 13 30 60, E-mail: h.krarup{at}rn.dk. Stephen Magesa, National Institute for Medical Research, Ubwari Research Station, P.O. Box 81, Muheza, Tanzania, Telephone: +255–27–2641132, Fax: +255–27–2643869, E-mail: smagesa{at}nimr.or.tz. Henrik Friis, Department of Human Nutrition, University of Copenhagen, Rolighedsvej 30, 1958 Frederiksberg, Denmark, Telephone: +45 35 28 38 70, Fax: +45 35 28 24 83, E–mail: hfr{at}life.ku.dk.

Reprint requests: Nina O. Nielsen, DBL—Centre for Health Research and Development, Department of Veterinary Pathobiology, Faculty of Life Sciences, University of Copenhagen, Jægersborg Allé 1D, 2920 Charlottenlund, Denmark, E-mail: nnielsen{at}dblnet.dk.

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