Diagnosing schistosomiasis-induced liver morbidity: implications for global control

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• 作者：David U. Olveda^a ; Marianette Inobaya^a ; ^b ; Remigio M. Olveda^b ; Marilyn L. Vinluan^b ; Shu-Kay Ng^a ; Kosala Weerakoon^c ; Donald P. McManus^c ; Grant A. Ramm^c ; ^d ; Donald A. Harn^e ; Yuesheng Li^c ; ^f ; Alfred K. Lam^a ; Jerric R. Guevarra^b ; Allen G. Ross^a ;
• 关键词：Schistosomiasis ; Morbidity ; Ultrasound ; Liver fibrosis ; Serum makers
• 刊名：International Journal of Infectious Diseases
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：54
• 期：Complete
• 页码：138-144
• 全文大小：758 K
• 卷排序：54

文摘

Subclinical morbidity due to schistosomiasis was evaluated in 565 patients, and the enhanced liver fibrosis (ELF) test was assessed for the first time as a potential screening tool for disease.MethodsThe prevalence and intensity of infection were determined by Kato–Katz thick smear stool examination at baseline and 2 years after curative treatment. The degree of hepatic fibrosis was assessed by ultrasound. Non-invasive serum biomarkers of hepatic fibrosis were also evaluated.ResultsThe baseline human prevalence and infection intensity were found to be moderately high at 34% and 123 eggs per gram, respectively. However, hepatic parenchymal fibrosis occurred in 50% of subjects, with grade II fibrosis in 19% and grade III in 6%. The ELF score and higher serum levels of tissue inhibitor of metalloproteinase 1 (TIMP-1) and hyaluronic acid (HA) correlated with the grade of liver fibrosis.ConclusionsThe findings of this study demonstrated that praziquantel treatment had a short-term impact on both the prevalence and intensity of infection, but less of an impact on established morbidity. Higher TIMP-1 and HA serum levels, and an ELF cut-off score of 8 were found to be correlated with the grade of liver fibrosis; these values may, therefore, assist physicians in identifying individuals at greater risk of disease.