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Herrick J. A., Legrand F., Gounoue R., Nchinda G., Montavon Céline, Bopda J., Tchana S. M., Ondigui B. E., Nguluwe K., Fay M. P., Makiya M., Metenou S., Nutman T. B., Kamgno J., Klion A. D. (2017). Posttreatment reactions after single-dose diethylcarbamazine or ivermectin in subjects with Loa loa infection. Clinical Infectious Diseases, 64 (8), 1017-1025. ISSN 1058-4838

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Lien direct chez l'éditeur doi:10.1093/cid/cix016

Titre
Posttreatment reactions after single-dose diethylcarbamazine or ivermectin in subjects with Loa loa infection
Année de publication2017
Type de documentArticle référencé dans le Web of Science WOS:000397809800004
AuteursHerrick J. A., Legrand F., Gounoue R., Nchinda G., Montavon Céline, Bopda J., Tchana S. M., Ondigui B. E., Nguluwe K., Fay M. P., Makiya M., Metenou S., Nutman T. B., Kamgno J., Klion A. D.
SourceClinical Infectious Diseases, 2017, 64 (8), p. 1017-1025. ISSN 1058-4838
RésuméBackground. Severe adverse reactions have been observed in individuals with Loa loa infection treated with either diethylcarbamazine (DEC), the drug of choice for loiasis, or ivermectin (IVM), which is used in mass drug administration programs for control of onchocerciasis and lymphatic filariasis in Africa. In this study, posttreatment clinical and immunologic reactions were compared following single-dose therapy with DEC or IVM to assess whether these reactions have the same underlying pathophysiology. Methods. Twelve patients with loiasis and microfilarial counts < 2000 mf/mL were randomized to receive single-dose DEC (8 mg/kg) or IVM (200 mu g/kg). Clinical and laboratory assessments were performed at 4, 8, 24, 48, and 72 hours and 5, 7, 9, and 14 days posttreatment. Results. Posttreatment adverse events were similar following DEC or IVM, but peaked earlier in subjects who received DEC, consistent with a trend toward more rapid and complete microfilarial clearance in the DEC group. After a transient rise (post-IVM) or fall (post-DEC) in the first 24 hours posttreatment, the eosinophil count rose significantly in both groups, peaking at day 5 in the DEC group and day 9 in the IVM group. Serum interleukin 5 levels and eosinophil activation, as assessed by surface expression of CD69 and serum levels of eosinophil granule proteins, were increased posttreatment in both groups. Conclusions. Despite differences in eosinophil and lymphocyte counts during the first 24 hours posttreatment, the overall pattern of hematologic and immunologic changes suggest that posttreatment reactions following DEC and IVM share a common pathophysiology.
Plan de classementEntomologie médicale / Parasitologie / Virologie [052] ; Santé : généralités [050]
Descr. géo.CAMEROUN
LocalisationFonds IRD [F B010069364]
Identifiant IRDfdi:010069364
Lien permanenthttp://www.documentation.ird.fr/hor/fdi:010069364

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