Efficacy of Ivermectin for Control of Microfilaremia Recurring after Treatment with Diethylcarbamazine

II. Immunologic Changes Following Treatment

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  • Guizhou Provincial Institute of Parasitic Diseases and Guizhou Provincial Institute of Pharmacology and Drug Control, Tongren and Zunyi Prefecture Sanitary and Antiepidemic Stations, Harvard School of Public Health, Guiyang, Guizhou, People's Republic of China

We compared the effect of a single dose of ivermectin with that of a standard course of diethylcarbamazine (DEC) on several parameters of the host's antifilarial immune response in 60 patients with bancroftian filariasis enrolled in a double-blind drug trial. All participants had measurable serum levels of antifilarial antibodies and parasite antigens at the onset of the study. Drug-induced clearance of microfilaremia was associated with a temporary increase in HC 11 antigenemia and a decrease in serum levels of antibodies to soluble filarial antigens. Antigenemia progressively declined in patients who remained amicrofilaremic. Treatment triggered a sustained increase in serum levels of interleukin-1, tumor necrosis factor, and interleukin-6 in all patients studied. Although ivermectin and DEC are believed to exert their antiparasite activity via different mechanisms, the same pattern of serologic changes was observed in patients treated with either drug.