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Anti-HCV-positive cirrhosis associated with schistosomiasis
A Koshy1, B al-Nakib, S al-Mufti
1Faculty of Medicine, Kuwait University.
Insights
Hepatitis C virus (HCV) infection is common in patients with hepatosplenic schistosomiasis and cirrhosis. Screening for anti-HCV is recommended in these patients to detect co-infection.
Area of Science:
- Hepatology
- Infectious Diseases
- Parasitology
Background:
- Hepatosplenic schistosomiasis can lead to cirrhosis and liver failure.
- Co-infection with other liver pathogens may worsen disease progression.
Purpose of the Study:
- To determine the prevalence of hepatitis C virus (HCV) antibody in patients with schistosomiasis and cirrhosis.
Main Methods:
- Study included 12 patients with schistosomiasis and biopsy-proven cirrhosis.
- Assessed anti-HCV antibody using ELISA.
- Hepatic catheterization performed on 5 patients.
Main Results:
- 83% (10/12) of patients were positive for anti-HCV.
- Patients exhibited signs of chronic liver disease, including ascites and edema.
- Hepatic catheterization revealed sinusoidal involvement.
Conclusions:
- Hepatitis C virus infection should be suspected in patients with schistosomiasis and cirrhosis.
- Co-infection may contribute to the severity of liver disease.
Abstract:
Hepatosplenic schistosomiasis is occasionally associated with cirrhosis and progressive hepatic decompensation. The aim of the present study was to determine the prevalence of antibody to hepatitis C virus in patients with schistosomiasis and cirrhosis. The prevalence of anti-HCV was studied in 12 consecutive cases of schistosomiasis associated with biopsy proven cirrhosis. All patients had a past history of schistosomiasis and high titers of schistosomal antibodies in serum (1:32 to 1:4096). Five of the 12 patients had hepatic catheterization and were found to have sinusoidal involvement with corrected sinusoidal pressures ranging from 19 to 23 mm Hg. Four had ascites, six had pedal edema, and eight had peripheral signs of chronic liver disease in the form of palmar erythema, spider nevi, and/or gynecomastia. Ten of the 12 cases (83%) were repeatedly positive for anti-HCV/ELISA. These results suggest that when patients with schistosomiasis develop cirrhosis, associated hepatitis C virus infection should be suspected.