Onchocerciasis and human immunodeficiency virus in western Uganda: prevalences and treatment with ivermectin

Epidemiologic investigations were made to assess the interaction between onchocerciasis and human immunodeficiency (HIV) type 1 infection and the efficacy of ivermectin treatment. Among 1,910 Onchocerca volvulus carriers in a hyperendemic focus, 73 (3.8%) were concurrently infected with HIV and 20 (7.2%) of 276 persons without microfilariae (mf) were HIV-seropositive. A stratified analysis showed no epidemiologic association between onchocerciasis and HIV infection. Consistently, a microfilaria density of 11.9 mf/mg of skin in HIV-positive subjects and 17.7 mf/mg in HIV-negatives ones was observed. During mass treatment of onchocerciasis with a single dose of 150 micrograms/kg of ivermectin, no difference of the efficacy was detected between persons with or without HIV and side effects in the two groups were similar. Even in HIV-positive persons with a reduced ratio of CD4+:CD8+ cells and reduced numbers of CD4+ cells, a significant reduction of their microfilaria density was observed after treatment with ivermectin. Thus, in HIV-endemic areas, the usual dose of ivermectin can be administered during mass treatment.