Prevalence and risk factors for blood filariasis among HIV-infected adults in Gabon, Central Africa: a pilot study

Trans R Soc Trop Med Hyg. 2022 Nov 1;116(11):1015-1021. doi: 10.1093/trstmh/trac034.

Abstract

Background: The level of blood filariasis parasitaemia as well as the frequency of and the relationship between cotrimoxazole prophylaxis (CTX-P), antiretroviral therapy (ART) intake and CD4 cell count among people living with human immunodeficiency virus (PLHIV) in rural areas of Gabon were being studied.

Methods: Sociodemographic data and recent biological tests of PLHIV and HIV-negative participants were collected. Loa loa and Mansonella perstans microfilaria were detected by direct microscopy examination and leucoconcentration.

Results: Overall, 209 HIV-positive and 148 HIV-negative subjects were enrolled. The overall prevalence of microfilaria was comparable between PLHIV (19.9% [n=41/206]) and HIV-negative participants (14.8% [n=22/148]) (p=0.2). The L. loa infection rate was comparable between HIV-positive (9.2%) and HIV-negative participants (6.8%) (p=0.2), while the M. perstans infection rate was 14-fold higher among PLHIV (p<0.01). L. loa parasitaemia was 6-fold lower in PLHIV receiving CTX-P (median 150 mf/mL [interquartile range {IQR} 125-350]) than in patients without (900 [550-2225]) (p<0.01). Among subjects with a CD4 cell count <200 cells/μL, the prevalence of M. perstans was 7-fold higher than that of L. loa (20.6% vs 2.9%).

Conclusions: This study suggests a similar exposure to L. loa infection of PLHIV and HIV-negative patients while M. perstans is more frequently found in HIV-positive individuals, notably those with a CD4 count <200 cells/μL.

Keywords: Loa loa; Mansonella perstans; Gabon; HIV; rural areas.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • Filariasis* / drug therapy
  • Gabon / epidemiology
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Humans
  • Loiasis* / epidemiology
  • Parasitemia / drug therapy
  • Pilot Projects
  • Prevalence
  • Risk Factors
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Trimethoprim, Sulfamethoxazole Drug Combination