03376nas a2200373   4500000000100000008004100001653002500042653001300067653002500080653000800105653001800113100001300131700001400144700001400158700001300172700001300185700001400198700001400212700001200226700001400238700001300252700001200265700001300277700001300290700001500303700001500318700001500333700001600348245015300364856009000517300000900607490000700616520237900623       2016                            d10aWuchereria bancrofti10aTanzania10aLymphatic filariasis10aHIV10aCo-infections1 aKroidl I1 aSaathof E1 aMaganga L1 aClowes P1 aMaboko L1 aHoerauf A1 aMakunde W1 aHaule A1 aMviombo P1 aPitter B1 aMgeni N1 aMabuye J1 aKowuor D1 aMwingira U1 aMalecela M1 aLöscher T1 aHoelscher M00aPrevalence of lymphatic filariasis and treatment effectiveness of Albendazole/Ivermectin in individuals with HIV co-infection in Southwest-Tanzania.  uhttp://journals.plos.org/plosntds/article/asset?id=10.1371%2Fjournal.pntd.0004618.PDF  a1-120 v103 a<p><strong>Background</strong>. 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.</p>

<p><strong>Methodology</strong>. In a general population study in Southwest Tanzania, individuals were tested for HIV and circulating filarial antigen, an indicator of <em>Wuchereria bancrofti</em> adult worm burden, before the first and after 2 consecutive rounds of anti-filarial mass drug administration.</p>

<p><strong>Principle Findings</strong>. 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).</p>

<p><strong>Conclusion/Significance</strong>. 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.</p>