Effect of aggressive prolonged diethylcarbamazine therapy on circulating antigen levels in bancroftian filariasis.
Effect of aggressive prolonged diethylcarbamazine therapy on circulating antigen levels in bancroftian filariasis.
复制标题
长期积极的二乙基卡马嗪治疗对班克罗夫特丝虫病循环抗原水平的影响。
DOI：
10.1046/j.1365-3156.2001.00666.x
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
Braga,C
中科院分区：
文献类型：
--
作者：
Freedman,DO;Plier,DA;DeAlmeida,AB;DeOliveira,AL;Miranda,J;Braga,C
BACKGROUNDSingle dose diethylcarbamazine (DEC) as used in control programmes is effectively microfilaricidal for periods of up to a year or more but has incomplete ability to killWuchereria bancroftiadult parasites. These regimens can be effective in breaking transmission by suppression of circulating microfilariae available to mosquito vectors. Whether prolonged or aggressive therapy with DEC has a significant effect on adult worms, which may live up to 12 years or more, and is important in the context of the treatment of individual patients, is still incompletely understood.METHODSIn order to investigate the adulticidal effect of aggressive therapy, DEC was given at 6 mg/kg/day for 12‐day courses at 0, 6, 12, and 18 months and Og4C3 antigenaemia followed over two years in 38 CAg + Brazilians in aW. bancroftiendemic area.RESULTSAt two year follow‐up, the median level of antigenaemia was 21% of the pre‐treatment value. 92% of individuals had antigen levels < 50% of pretreatment values, but only 26% had completely cleared antigenaemia. The clearance rate at 24 months was only 12% (3/26) in the asymptomatic CAg + patients but 58% (7/12) in those with clinical manifestations of filariasis. The latter individuals cleared significantly more antigen (median of 0% pretreatment antigenaemia vs. 26%;P=0.02) than asymptomatic but infected individuals.CONCLUSIONAggressive repeated therapy with DEC alone is ineffective in consistently eradicating adultW. bancrofti, especially in infected but asymptomatic individuals. Prolonged courses of combination therapy with other antifilarial drugs should be investigated for treatment of individual patients with the means to pursue aggressive personal medical care.
