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Effects of albendazole on the clinical outcome and immunological responses in helminth co-infected tuberculosis patients: a double blind randomised clinical trial
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences. University of Gondar, Ethiopia.
University of Southern Denmark, Denmark.
University of Gondar, Ethiopia.
University of Gondar, Ethiopia.
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2015 (English)In: International Journal of Parasitology, ISSN 0020-7519, E-ISSN 1879-0135, Vol. 45, no 2-3, 133-140 p.Article in journal (Refereed) Published
Abstract [en]

Despite several review papers and experimental studies concerning the impact of chronic helminth infection on tuberculosis in recent years, there is a scarcity of data from clinical field studies in highly endemic areas for these diseases. We believe this is the first randomised clinical trial investigating the impact of albendazole treatment on the clinical and immunological outcomes of helminth co-infected tuberculosis patients. A randomised, double-blind, placebo-controlled trial of albendazole (400 mg per day for 3 days) in helminth-positive tuberculosis patients was conducted in Gondar, Ethiopia. The primary outcome was clinical improvement (Delta TB score) after 2 months. Among secondary outcomes were changes in the levels of eosinophils, CD4+ T cells, regulatory T cells, IFN-gamma, IL-5 and IL-10 after 3 months. A total of 140 helminth co-infected tuberculosis patients were included with an HIV co-infection rate of 22.8%. There was no significant effect on the primary outcome (Delta TB score: 5.6 +/- 2.9 for albendazole versus 5.9 +/- 2.5 for placebo, P = 0.59). The albendazole-treated group showed a decline in eosinophil cells (P = 0.001) and IL-10 (P = 0.017) after 3 months. In an exploratory analysis after 12 weeks, the albendazole treated group showed a trend towards weight gain compared with the placebo group (11.2 +/- 8.5 kg versus 8.2 +/- 8.7 kg, P = 0.08)). The reductions in eosinophil counts and IL-10 show that asymptomatic helminth infection significantly affects host immunity during tuberculosis and can be effectively reversed by albendazole treatment. The clinical effects of helminth infection on chronic infectious diseases such as tuberculosis merit further characterisation. (C) 2014 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
Elsevier , 2015. Vol. 45, no 2-3, 133-140 p.
Keyword [en]
Helminth; Tuberculosis; Albendazole; Deworming; HIV; Ethiopia
National Category
Clinical Medicine
URN: urn:nbn:se:liu:diva-116974DOI: 10.1016/j.ijpara.2014.09.006ISI: 000350936200006PubMedID: 25486494OAI: diva2:802115

Funding Agencies|Swedish Research Council; Swedish Heart and Lung Foundation; King Oscar II Jubilee Foundation; SIDA/SAREC; European and Developing Countries Clinical Trials Partnership (EDCTP) [JP]; Groschinsky Memorial Foundation; Marianne and Marcus Wallenberg foundation

Available from: 2015-04-10 Created: 2015-04-10 Last updated: 2015-04-10

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Stendahl, OlleSchön, Thomas
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