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Title Wolbachia endobacteria depletion by doxycycline as antifilarial therapy has macrofilaricidal activity in onchocerciasis: a randomized placebo-controlled study
Author Achim Hoerauf, Sabine Specht, Marcelle Buttner, Kenneth Pfarr, Sabine Mand, Rolf Fimmers, Yeboah Marfo-Debrekyei, Peter Konadu, Alexander Yaw Debrah, Claudio Bandi, Norbert Brattig, Anna Albers, John Larbi, Linda Bats, Mark J. Taylor, Ohene Adjei, Dietrich W. Buttne
In a randomized, placebo-controlled trial in Ghana, 67 onchocerciasis patients received 200-mg/day doxycycline for 4–6 weeks, followed by ivermectin (IVM) after 6 months. After 6–27 months, efficacy was evaluated by onchocercoma histology, PCR and microfilariae determination. Administration of doxycycline resulted in endobacteria depletion and female worm sterilization. The 6-week treatment was macrofilaricidal, with >60% of the female worms found dead, despite the presence of new, Wolbachia-containing worms acquired after the administration of doxycycline. Doxycycline may be developed as second-line drug for onchocerciasis, to be administered in areas without transmission, in foci with IVM resistance and in areas with Loa co-infections.

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Keywords Doxycycline - Ghana - ivermectin - macrofilaricidal - Onchocerca volvulus - Wolbachia
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