Seeking Therapeutic Options to Prevent Filarial infections and post-Ivermectin Loa-related Adverse Reactions – STOP-FiLAR
The control of onchocerciasis, a disease due to a parasitic worm (a filaria) found in 31 African countries, relies on the mass treatment (without prior individual diagnosis) of the population living in meso-hyperendemic areas. Loiasis (Loa loa filariasis) is not subject to specific control programs but impedes onchocerciasis elimination activities in coendemic areas because ivermectin can induce encephalopathy in subjects with high microfilarial density of Loa in the blood.
In areas where onchocerciasis is hypoendemic and coexists with Loa, the risk of serious adverse events outweighs the benefits of ivermectin treatment and mass distributions are therefore proscribed. As these hypoendemic areas should still be treated to eliminate onchocerciasis, alternative strategies must be applied. One option would be to pretreat the whole population of these areas with a drug that is safe and progressively reduces the Loa microfilarial density below the risk threshold for serious adverse events. A second strategy would be to pretreat only individuals with high Loa density. Within this pretreatment framework, we propose to evaluate 2 regimens: a 3- or 5-day course of levamisole (a drug which has been shown to be safe at single-dose in Loa-infected subjects), and a 21-day course of albendazole (this regimen gradually reduces Loa microfilaremia but has never been evaluated in subjects with high microfilarial density). A third strategy that could accelerate elimination of onchocerciasis would be to distribute a safe and effective prophylactic drug to endemic populations (whether people are infected or not). We propose to evaluate the prophylactic potential of 3 molecules: ivermectin, moxidectin and albendazole. This treatment could also be offered to temporary visitors to endemic areas.
Monsieur Jérémy Campillo (Recherche translationnelle sur VIH et les Maladies Infectieuses endémiques et émergentes)
The author of this summary is the project coordinator, who is responsible for the content of this summary. The ANR declines any responsibility as for its contents.
TransVIHMI Recherche translationnelle sur VIH et les Maladies Infectieuses endémiques et émergentes
Help of the ANR 532,110 euros
Beginning and duration of the scientific project: January 2023 - 24 Months