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

Nina O. Nielsen DBL—Centre for Health Research and Development, University of Copenhagen, Copenhagen, Denmark; Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark; National Institute for Medical Research, Ubwari Research Station, Tanzania; Department of Human Nutrition, University of Copenhagen, Copenhagen, Denmark

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Paul E. Simonsen DBL—Centre for Health Research and Development, University of Copenhagen, Copenhagen, Denmark; Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark; National Institute for Medical Research, Ubwari Research Station, Tanzania; Department of Human Nutrition, University of Copenhagen, Copenhagen, Denmark

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Peter Dalgaard DBL—Centre for Health Research and Development, University of Copenhagen, Copenhagen, Denmark; Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark; National Institute for Medical Research, Ubwari Research Station, Tanzania; Department of Human Nutrition, University of Copenhagen, Copenhagen, Denmark

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Henrik Krarup DBL—Centre for Health Research and Development, University of Copenhagen, Copenhagen, Denmark; Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark; National Institute for Medical Research, Ubwari Research Station, Tanzania; Department of Human Nutrition, University of Copenhagen, Copenhagen, Denmark

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Pascal Magnussen DBL—Centre for Health Research and Development, University of Copenhagen, Copenhagen, Denmark; Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark; National Institute for Medical Research, Ubwari Research Station, Tanzania; Department of Human Nutrition, University of Copenhagen, Copenhagen, Denmark

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Stephen Magesa DBL—Centre for Health Research and Development, University of Copenhagen, Copenhagen, Denmark; Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark; National Institute for Medical Research, Ubwari Research Station, Tanzania; Department of Human Nutrition, University of Copenhagen, Copenhagen, Denmark

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Henrik Friis DBL—Centre for Health Research and Development, University of Copenhagen, Copenhagen, Denmark; Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark; National Institute for Medical Research, Ubwari Research Station, Tanzania; Department of Human Nutrition, University of Copenhagen, Copenhagen, Denmark

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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.

Author Notes

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@dblnet.dk.
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