C-REACTIVE PROTEIN AND INTERLEUKIN-6 ARE ELEVATED IN ONCHOCERCIASIS PATIENTS AFTER IVERMECTIN TREATMENT

Ivermectin treatment of onchocerciasis can induce adverse reactions. M echanisms underlying these reactions are poorly understood but may inc lude activation of neutrophils. This study investigated the acute-phas e response in onchocerciasis patients during 2 days after ivermectin t reatment. The acute-phase protein C-reactive protein (CRP) and cytokin es that mediate the acute-phase response (tumor necrosis factor-alpha [TNF alpha] and interleukin-6 [IL-6]) were measured in 144 skin snip-p ositive onchocerciasis patients and 12 skin snip-negative controls who received one dose of ivermectin (150 mu g/kg). No elevated TNF alpha levels were found, but IL-6 and CRP were elevated in 25.7% and 50.7% o f the patients, respectively, after ivermectin treatment. Most patient s (89.2%) with raised IL-6 also had raised CRP. Such increases were no t observed in controls and in patients were correlated with adverse re actions and microfilarial densities. These findings suggest a possible role of the acute-phase response in microfilarial destruction followi ng ivermectin treatment.