Diagnosing schistosomiasis-induced liver morbidity: implications for global control. (January 2017)

• Record Type: Journal Article
• Authors: Olveda, David U.; Inobaya, Marianette; Olveda, Remigio M.; Vinluan, Marilyn L.; Ng, Shu-Kay; Weerakoon, Kosala; McManus, Donald P.; Ramm, Grant A.; Harn, Donald A.; Li, Yuesheng; Lam, Alfred K.; Guevarra, Jerric R.; Ross, Allen G.
• Is Part Of: International journal of infectious diseases. Volume 54(2017:Jan.)
• Page Start: 138
• Page End: 144
• Publication Date: 2017-01
• Subjects: Schistosomiasis -- Morbidity -- Ultrasound -- Liver fibrosis -- Serum makers; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2016.10.024
• Languages: English
• ISSNs: 1201-9712

Abstract

Summary: Background: 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. Methods: The 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. Results: The 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. Conclusions: The 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.