WP9: Elucidating the role of HIV therapy on LF pathology.

This task aims to investigate the influence of Human Immunodeficiency Virus (HIV) on chronic LF disease manifestations such as LE and hydrocele. LE and hydrocele pathology development in LF is, in part, immune-mediated. Rollout of anti-retroviral therapy (ART) throughout sub-Saharan African countries will lead to immune reconstitution in HIV-infected persons with low CD4 cell counts. In several other diseases, “immune-reconstitution inflammatory syndrome” (IRIS) has been described as leading to inflammation in previously clinically healthy participants, when CD4 cells begin to rise. Since chronic pathology in LF is associated with pro-inflammatory reactions, it has been hypothesised that reconstitution of the immune system after ART in LF infected patients might lead to enhanced development of clinical disease. Because progression in disease due to ART therapy in LF patients could compromise the compliance and adherence of LF/ HIV co-infected patients, the effects of ART must be elucidated in areas of co-endemicity, especially because this has been rarely studied. It is suggested that these pro-inflammatory effects could easily be avoided by doxycycline treatment of co-infected individuals. This task will be led by Dr. Upendo Mwingira, and Dr. Inge Kroidl.