Albendazole treatment of HIV-1 and helminth co-infection: a randomized, double-blind, placebo-controlled trial.
Albendazole treatment of HIV-1 and helminth co-infection: a randomized, double-blind, placebo-controlled trial.
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DOI：
10.1097/qad.0b013e32830a502e
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发表时间：
2008-08-20
期刊：
影响因子：
3.8
通讯作者：
John-Stewart, Grace C.
中科院分区：
文献类型：
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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.
一些混合感染已被证明影响艾滋病毒-1感染的进展。我们试图确定HIV-1感染成人中蠕虫合并感染的治疗是否影响HIV-1疾病进展的标志物。到目前为止，还没有随机试验来检验土壤传播的蠕虫根除对艾滋病毒-1进展标志物的影响。在肯尼亚的十个地点进行了一项随机、双盲、安慰剂对照的阿苯达唑试验(每天400毫克，连续三天)，用于土源性蠕虫感染的抗逆转录病毒感染的成人(CD4>；200个/mm3)(临床试验.gov NCT00130910)。在随机试验后12周，使用线性回归对试验组的CD4和血浆HIV-1RNA水平进行比较，并对基线值进行调整。在对1551名艾滋病毒-1感染者进行蠕虫感染筛查中，299人感染了蠕虫。234名成年人入选并接受了随机分组，208名个人被纳入意向治疗分析。登记时，平均CD4细胞数为557个/mm3，平均血浆病毒载量为4.75log10拷贝/毫升。阿苯达唑治疗12周后，蛔虫感染者的CD_4细胞显著增加(+109cell/mm~3；95%CI+38.9to+179.0，p=0.003)，HIV-1RNA水平下降0.54log10(p=0.09)。在处理其他种类的土传蠕虫时，这些影响并不明显。在3个月的随访中，在HIV-1合并感染的成人中，用阿苯达唑治疗伦布氏假丝酵母菌后，CD4计数显著增加。鉴于世界范围内蛔虫感染的高流行率，驱虫可能是延缓HIV-1进展的一个重要的潜在策略。
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. To date there have been no randomized trials to examine the effects of soil-transmitted helminth eradication on markers of HIV-1 progression. 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. 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. 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.