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Impact of hepatitis C virus infection on schistosomal liver disease
A Mohamed1, A Elsheikh, Z Ghandour
1Department of Gastroenterology, Armed Forces Hospital, Riyadh, Saudi Arabia.
Insights
Hepatitis C virus (HCV) infection significantly worsens liver function in patients with schistosomiasis, leading to earlier decompensation and promoting severe liver disease at a younger age. This highlights HCV as a critical factor in schistosomal liver disease progression.
Area of Science:
- Hepatology
- Infectious Diseases
- Gastroenterology
Background:
- Schistosomiasis is a parasitic disease causing liver damage and portal hypertension.
- The role of co-infection with Hepatitis C virus (HCV) in schistosomal liver disease progression is not fully understood.
Purpose of the Study:
- To investigate the impact of Hepatitis C virus infection on patients with schistosomal liver disease.
Main Methods:
- A comparative study of 60 patients with hepatosplenic schistosomiasis and portal hypertension.
- Group one: 30 patients with HCV infection. Group two: 30 patients without HCV infection (control).
- Assessment included liver function tests, liver biopsy, and alpha-fetoprotein levels.
Main Results:
- HCV-positive patients showed significantly elevated ALT levels (83.3% vs. 23.4%).
- HCV co-infection was associated with chronic active hepatitis, cirrhosis (31.6%), and hepatocellular carcinoma (HCC).
- HCV-positive patients developed HCC and cirrhosis at a younger age compared to controls.
Conclusions:
- Hepatitis C virus infection is a significant factor in the deterioration of liver function in schistosomal liver disease.
- HCV accelerates liver decompensation and promotes severe liver disease earlier in patients with schistosomiasis.
- Early detection and management of HCV in schistosomiasis patients are crucial to prevent advanced liver disease.
Background/Aims:
This study was conducted to determine whether Hepatitis C virus infection has a role in patients with schistosomal liver disease.
Methodology:
Sixty patients with hepatosplenic schistosomiasis and evidence of portal hypertension were seen at the Armed Forces Hospital Riyadh, Saudi Arabia over 5 years. The impact of Hepatitis C virus infection on chronic schistosomal liver disease was studied in 30 of these patients (group one) who were Hepatitis C virus positive and compared with the other 30 patients (group two) who were Hepatitis C virus negative (control group).
Results:
Hepatitis C virus may be an important factor contributing to deterioration of liver function for patients with hepatosplenic schistosomiasis. Liver functions showed elevated ALT in 83.3% in group one compared to 23.4% in group two. Liver biopsy in 19 patients (group one) and 16 patients (group two) showed evidence of schistosomiasis and in patients of group one, liver biopsy also showed chronic active hepatitis together with Schistosoma in 57.9%, and cirrhosis in 31.6%. None of group two patients had cirrhosis. Alpha-fetoprotein levels were elevated in 16 patients (group one) and 3 of these patients had hepatocellular carcinoma. None of the control group had radiological or histological evidence of hepatocellular carcinoma.
Conclusion:
The mean age of HCV positive patients was less than the HCV negative patients, which may indicate that Hepatitis C virus infection leads to decompensation of liver function earlier in patients with Schistosoma and severe liver disease may be promoted at a younger age in Schistosoma patients with hepatitis C.