Albendazole treatment of HIV-1 and helminth co-infection: a randomized, double-blind, placebo-controlled trial

作者：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 H; John Stewart Grace C

来源：AIDS, 2008, 22(13): 1601-1609.

DOI：10.1097/qad.0b013e32830a502e

• co-infection
• helminth
• HIV-1 progression

Objective: 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 albenclazole (400 mg daily for 3 clays) in antiretroviral-naive HIV-1-infected adults (CD4 cell count >200 cells/mu l) with oil-transmitted helminth infection was conducted at 10 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 1551 HIV-1-infected individuals screened for helminth infect ion, 2 99 were helminth infected. Two hundred and thirty-four adults were enrolled and Underwent randomization and 208 individuals Were includes in intent-to-treat analyses. Mean CD4 cell count was 557 cells/mu l and mean plasma viral load was 4.75 logl(10) copies/ml at enrollment. Albendazole therapy resulted in significantly higher CD4 cell counts among individuals with Ascaris lumbricoides infection after 12 weeks of follow-up (+109cells/mu l; 95% confidence interval +38.9 to +179.0, P=0.003) and a trend for 0.54 log(10) lower HIV-1 RNA levels (P=0.09). These effects were not seen with treatment of other species of soil-transmitted helminths.
Conclusion: Treatment of A. lumbricoides with albenclazole in HIV-1-coinfected adults resulted in significantly increased CD4 cell counts during 3-month follow-up. Given the high prevalence of A. lumbricodies infection worldwide, deworming may be all important potential strategy to delay HIV-1 progression.

• 出版日期2008-8-20