Albendazole treatment of HIV-1 and helminth co-infection: A randomized, double blind, placebo-controlled trial
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Date
2008Author
Walson, Judd L
Otieno, Phelgona A
Mbuchi, Margaret
Richardson, Barbra A
Lohman-Payne, Barbara
Macharia, Steve Wanyee
Overbaugh, Julie
Berkley, James
Sanders, Eduard J
Chung, Michael
John-Stewart, Grace C
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Several co-infections have been shown to impact the progression of HIV-1 infection. We sought to determine if treatment of helminth co-infection in HIV-1 infected adults impacted markers of HIV-1 disease progression.
DESIGN
To date there have been no randomized trials to examine the effects of soil-transmitted helminth eradication on markers of HIV-1 progression.
METHODS
A randomized, double-blind, placebo-controlled trial of albendazole (400mg daily for three days) in antiretroviral-naïve HIV-1 infected adults (CD4 >200 cells/mm3) with soil-transmitted helminth infection was conducted at ten sites in Kenya (Clinical Trials.gov NCT00130910). CD4 and plasma HIV-1 RNA levels at 12 weeks following randomization were compared in the trial arms using linear regression, adjusting for baseline values.
RESULTS
Of 1,551 HIV-1 infected individuals screened for helminth-infection, 299 were helminth-infected. 234 adults were enrolled and underwent randomization and 208 individuals were included in intent-to-treat analyses. Mean CD4 count was 557 cells/mm3 and mean plasma viral load was 4.75 log10 copies/mL at enrolment. Albendazole therapy resulted in significantly higher CD4 counts among individuals with Ascaris lumbricoides infection after 12 weeks of follow up (+109 cells/mm3; 95% CI +38.9 to +179.0, p=0.003) and a trend for 0.54 log10 lower HIV-1 RNA levels (p=0.09). These effects were not seen with treatment of other species of soil-transmitted helminths.
CONCLUSIONS
Treatment of A. lumbricoides with albendazole in HIV-1 co-infected adults resulted in significantly increased CD4 counts during 3-month follow-up. Given the high prevalence of A. lumbricoides infection worldwide, deworming may be an important potential strategy to delay HIV-1 progression.
URI
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2637615/http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/42969
Citation
AIDS. 2008 August 20; 22(13): 1601–1609.Publisher
Centre for Clinical Research, Kenya Medical Research Institute, Kenya Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute, Kenya University of Nairobi, Department of Pediatrics, Nairobi, Kenya University of Nairobi, Obstetrics and Gynecology, Nairobi, Kenya Department of Medicine, University of Washington, Seattle, WA Department of Biostatistics, University of Washington, Seattle, WA Department of Epidemiology, University of Washington, Seattle, WA Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Headington, UK
Collections
- Faculty of Health Sciences (FHS) [10377]