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Loa loa Microfilarial Periodicity in Ivermectin-Treated Patients: Comparison Between Those Developing and Those Free of Serious Adverse Events

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  • 1 Filariasis Research Centre and Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon; Unité Mixte de Recherche 145, Institut de Recherche pour le Développement and Université Montpellier 1, Montpellier, France; Filarial Diseases Unit, Michigan State University, East Lansing, Michigan; Mectizan Donation Program, Decatur, Georgia
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The main risk factor of post-ivermectin serious adverse events (SAEs) is the presence of a high Loa loa microfilaremia. However, the majority of patients with such high loads do not develop SAEs, suggesting that co-factors may be involved. An infection with simian Loa parasites, whose microfilariae show a nocturnal periodicity, might be such a co-factor. The periodicity of Loa microfilariae was compared, using cosinor methodology, in 4 patients who had developed a post-ivermectin neurologic SAE, 4 patients who had experienced a non-neurologic SAE, and 14 control individuals. The periodicity was similar in all three groups, with a peak of microfilaremia occurring between 12:30 and 2:00 pm. The results of this study, which for the first time characterizes the periodicity of Loa microfilariae mathematically, suggest that post-ivermectin SAEs are not related to an infection with a Loa simian strain.

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