Loiasis Treatment When Apheresis or Albendazole Did Not Reduce Microfilarial Load Below 8,000/mL
This protocol addresses patients with symptomatic loiasis whose microfilarial load remains at or above 8,000 microfilariae per mL of blood. In this population, a high parasite burden requires careful management before — or in determining readiness for — definitive treatment.
The initial step for this scenario was to reduce the microfilarial load to below 8,000 microfilariae per mL, using either apheresis at a specialised centre or albendazole for 21 days with re-measurement of levels. This protocol applies when that load-reduction goal was not met and the patient is being managed further.
The next step involves diethylcarbamazine (DEC), the drug of choice for loiasis. The full regimen — including schedule and duration — is detailed in the structured protocol.
The aim is cure, defined as resolution of symptoms, resolution of eosinophilia, and decreasing antifilarial antibody titers.
Symptomatic loiasis, with MF/mL ≥8,000
In those patients with microfilarial loads ≥8,000 microfilariae per mL, apheresis can be used in specialized centers to reduce the load below the 8,000 threshold prior to beginning treatment.
The drug of choice for the treatment of loiasis is diethylcarbamazine (DEC).
Most patients will achieve cure, defined as resolution of symptoms, resolution of eosinophilia, and decreasing antifilarial antibody titers, with one or two courses of DEC.
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