title: Prevalence of Lymphatic Filariasis and Treatment Effectiveness of Albendazole/ Ivermectin in Individuals with HIV Co-infection in Southwest-Tanzania.
abstract: BACKGROUND
  Annual mass treatment with ivermectin and albendazole is used to treat lymphatic filariasis in many African countries, including Tanzania. In areas where both diseases occur, it is unclear whether HIV co-infection reduces treatment success.
  
  
  METHODS
  In a general population study in Southwest Tanzania, individuals were tested for HIV and circulating filarial antigen, an indicator of Wuchereria bancrofti adult worm burden, before the first and after 2 consecutive rounds of anti-filarial mass drug administration.
  
  
  RESULTS
  Testing of 2104 individuals aged 0-94 years before anti-filarial treatment revealed a prevalence of 24.8% for lymphatic filariasis and an HIV-prevalence of 8.9%. Lymphatic filariasis was rare in children, but prevalence increased in individuals above 10 years, whereas a strong increase in HIV was only seen above 18 years of age. The prevalence of lymphatic filariasis in adults above 18 years was 42.6% and 41.7% (p = 0.834) in HIV-negatives and-positives, respectively. Similarly, the HIV prevalence in the lymphatic filariasis infected (16.6%) and uninfected adult population (17.1%) was nearly the same. Of the above 2104 individuals 798 were re-tested after 2 rounds of antifilarial treatment. A significant reduction in the prevalence of circulating filarial antigen from 21.6% to 19.7% was found after treatment (relative drop of 8.8%, McNemar's exact p = 0.036). Furthermore, the post-treatment reduction of CFA positivity was (non-significantly) larger in HIV-positives than in HIV-negatives (univariable linear regression p = 0.154).
  
  
  CONCLUSIONS
  In an area with a high prevalence for both diseases, no difference was found between HIV-infected and uninfected individuals regarding the initial prevalence of lymphatic filariasis. A moderate but significant reduction in lymphatic filariasis prevalence and worm burden was demonstrated after two rounds of treatment with albendazole and ivermectin. Treatment effects were more pronounced in the HIV co-infected subgroup, indicating that the effectiveness of antifilarial treatment was not reduced by concomitant HIV-infection. Studies with longer follow-up time could validate the observed differences in treatment effectiveness.
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany.|National Institute of Medical Research (NIMR)-Mbeya Medical Research Centre (MMRC), Mbeya, Tanzania.
authors.forename: Inge
authors.initials: I
authors.lastname: Kroidl
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany.|German Center for Infection Research (DZIF), Munich, Germany.
authors.forename: Elmar
authors.initials: E
authors.lastname: Saathof
authors.affiliation: National Institute of Medical Research (NIMR)-Mbeya Medical Research Centre (MMRC), Mbeya, Tanzania.
authors.forename: Lucas
authors.initials: L
authors.lastname: Maganga
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany.|National Institute of Medical Research (NIMR)-Mbeya Medical Research Centre (MMRC), Mbeya, Tanzania.
authors.forename: Petra
authors.initials: P
authors.lastname: Clowes
authors.affiliation: National Institute of Medical Research (NIMR)-Mbeya Medical Research Centre (MMRC), Mbeya, Tanzania.
authors.forename: Leonard
authors.initials: L
authors.lastname: Maboko
authors.affiliation: German Center for Infection Research (DZIF), Bonn-Cologne, Germany.|Institute of Medical Microbiology, Immunology and Parasitology, Bonn, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Hoerauf
authors.affiliation: National Institute of Medical Research (NIMR), Tanga, Tanzania.
authors.forename: Williams H
authors.initials: WH
authors.lastname: Makunde
authors.affiliation: National Institute of Medical Research (NIMR)-Mbeya Medical Research Centre (MMRC), Mbeya, Tanzania.
authors.forename: Antelmo
authors.initials: A
authors.lastname: Haule
authors.affiliation: National Institute of Medical Research (NIMR)-Mbeya Medical Research Centre (MMRC), Mbeya, Tanzania.
authors.forename: Prisca
authors.initials: P
authors.lastname: Mviombo
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany.|National Institute of Medical Research (NIMR)-Mbeya Medical Research Centre (MMRC), Mbeya, Tanzania.
authors.forename: Bettina
authors.initials: B
authors.lastname: Pitter
authors.affiliation: National Institute of Medical Research (NIMR)-Mbeya Medical Research Centre (MMRC), Mbeya, Tanzania.
authors.forename: Neema
authors.initials: N
authors.lastname: Mgeni
authors.affiliation: National Institute of Medical Research (NIMR)-Mbeya Medical Research Centre (MMRC), Mbeya, Tanzania.
authors.forename: Joseph
authors.initials: J
authors.lastname: Mabuye
authors.affiliation: National Institute of Medical Research (NIMR)-Mbeya Medical Research Centre (MMRC), Mbeya, Tanzania.
authors.forename: Dickens
authors.initials: D
authors.lastname: Kowuor
authors.affiliation: National Institute of Medical Research (NIMR), Dar es Salaam, Tanzania.
authors.forename: Upendo
authors.initials: U
authors.lastname: Mwingira
authors.affiliation: National Institute of Medical Research (NIMR), Dar es Salaam, Tanzania.
authors.forename: Mwelecele N
authors.initials: MN
authors.lastname: Malecela
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Löscher
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany.|National Institute of Medical Research (NIMR)-Mbeya Medical Research Centre (MMRC), Mbeya, Tanzania.|German Center for Infection Research (DZIF), Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hoelscher
mesh_terms: D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000953:Antigens, Protozoan / Q000097:blood; D060085:Coinfection / Q000188:drug therapy; D004605:Elephantiasis, Filarial / Q000188:drug therapy* / Q000453:epidemiology*; D005369:Filaricides / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use*; D015995:Prevalence; D013636:Tanzania / Q000453:epidemiology; D016896:Treatment Outcome; D014958:Wuchereria bancrofti / Q000187:drug effects / Q000302:isolation & purification
chemical_list: D000953:Antigens, Protozoan; D005369:Filaricides; D007559:Ivermectin; D015766:Albendazole