David U Olveda1, Marianette Inobaya2, Remigio M Olveda3, Marilyn L Vinluan3, Shu-Kay Ng1, Kosala Weerakoon4, Donald P McManus4, Grant A Ramm5, Donald A Harn6, Yuesheng Li7, Alfred K Lam1, Jerric R Guevarra3, Allen G Ross1. 1. Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia. 2. Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; Research Institute for Tropical Medicine, Department of Health, Manila, the Philippines. 3. Research Institute for Tropical Medicine, Department of Health, Manila, the Philippines. 4. QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. 5. QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia. 6. Center for Tropical and Emerging Global Health Diseases, University of Georgia, Athens, Georgia, USA. 7. QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; Hunan Institute of Parasitic Diseases, WHO Collaborating Center for research and Control of Schistosomiasis, Yueyang, Hunan, China.
Abstract
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.
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.
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