Chronic hepatitis B and liver schistosomiasis: a deleterious association

Andrade, José Ricardo Almeida de; Silva, Luciana Diniz; Guimarães, Camila Mendes; Bassetti-Soares, Eric; Cambraia, Rodrigo Dias; Couto, O. F. M.; Teixeira, Rosângela

doi:10.1093/trstmh/tru010

Cited by 17 publications

(11 citation statements)

References 36 publications

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“…This contrasts with recent investigations as those of Andrade et al [23] from Brazil. In their study, they too compare patients with chronic HBV infection with and without schistosomiasis, and do find differences in AST levels, platelet count, and cirrhosis prevalence.…”

Section: Discussioncontrasting

confidence: 94%

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Hepatitis B and Schistosoma co-infection in a non-endemic area

Cuenca-Gómez

Salas-Coronas

Lozano-Serrano

et al. 2016

Eur J Clin Microbiol Infect Dis

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Schistosomiasis is related to the development of liver fibrosis and portal hypertension. Chronic co-infection with HBV and Schistosoma has been associated in endemic areas with a higher risk for a more severe liver disease. However, no studies have assessed the real importance of this co-infection in non-endemic regions. This is a retrospective observational study of Sub-Saharan immigrants attending between October 2004 and February 2014. Patients with chronic HBV infection with and without evidence of schistosomal infection were compared. Epidemiological, analytical, and microbiological data were analysed. Likelihood of liver fibrosis based on APRI and FIB-4 indexes was established. A total of 507 patients were included in the study, 170 (33.5 %) of them harbouring evidence of schistosome infection. No differences were found in transaminase, GGT, and ALP levels. In fibrosis tests, a higher proportion of patients with HVB and S. mansoni detection reached possible fibrosis scores (F > 2) when compared to patients without schistosomiasis: 17.4 vs 14.2 % and 4.3 % vs 4.2 % (using high sensitivity and high specificity cut-offs respectively), although differences were not statistically significant (p = 0.69, p = 0.96). For possible cirrhosis (F4) score, similar results were observed: 4.3 % of co-infected patients vs 2.1 % of mono-infected ones, p = 0.46. According to these datas, in non-endemic regions the degree of hepatic fibrosis in patients with chronic hepatitis B is not substantially modified by schistosome co-infection.

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Section: Discussioncontrasting

confidence: 94%

“…Another relevant fact is that the studies performed in endemic areas, mainly Brazil and Egypt [10][11][12][13][14]23], include a high proportion of cirrhotic patients (from 31.5 to 48 %). On the contrary, in our series there were very few cirrhotic patients.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B and Schistosoma co-infection in a non-endemic area

Cuenca-Gómez

Salas-Coronas

Lozano-Serrano

et al. 2016

Eur J Clin Microbiol Infect Dis

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“…Thus, most published studies have found no association between schistosomiasis and worsening of HBV infection [ 53 ]. In contrast, other studies described a poor prognosis of HBV when associated with hepatosplenic schistosomiasis [ 17 , 24 , 54 ]. Interestingly HBV vaccines (both 1st and 2nd generation) can mount an immune response in schistosomiasis patients; however, reduced responses to vaccination were seen in hepatosplenic schistosomiasis [ 37 , 55 , 56 ].…”

Section: Introductionmentioning

confidence: 87%

Schistosomiasis, hepatitis B and hepatitis C co-infection

Gasim

Bella

Adam

2015

Virol J

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BackgroundSchistosomiasis is a significant health problem in more than 70 countries distributed between Africa, Asia and South America, with an infection rate of one in 30 individuals. Data on Schistosomiasis, Hepatitis B virus (HBV) and Hepatitis C virus (HCV) co-infection are scarce; however, there is a high prevalence in countries where schistosomiasis is endemic.MethodsA systematic search was performed on published data from 1980–2014. Published papers in the databases Google, Medline, PubMed, and MiPc library were searched using the keywords epidemiology, pathogenesis and outcomes of HBV, HCV and schistosomiasis and data were extracted from the relevant studies.ResultsThe prevalence of HBV/schistosomiasis co-infection in countries where schistosomiasis is endemic was high, ranging between 9.6 to approximately 64% in Egypt, and a maximum of 15.8% among hospitalized patients in Brazil. Concurrent infection between HBV and schistosomiasis is often associated with countries where schistosomiasis is endemic and may lead to chronic liver inflammation. Similarly, HCV infection rates in schistosomiasis populations range from 1% in Ethiopia reaching up to 50% in Egypt.ConclusionThere is controversy regarding the effects of HBV and HCV on schistosomiasis and vice versa. Vaccination might be a solution to the era of schistosomiasis and co-infection with HBV and HCV.

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“…Also, S . mansoni and hepatitis B co-infection has been associated with more severe liver disease [19]. …”

Section: Introductionmentioning

confidence: 99%

Schistosoma mansoni Infection Can Jeopardize the Duration of Protective Levels of Antibody Responses to Immunizations against Hepatitis B and Tetanus Toxoid

et al. 2016

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BackgroundSchistosomiasis is a disease of major public health importance in sub-Saharan Africa. Immunoregulation begins early in schistosome infection and is characterized by hyporesponsiveness to parasite and bystander antigens, suggesting that a schistosome infection at the time of immunization could negatively impact the induction of protective vaccine responses. This study examined whether having a Schistosoma mansoni infection at the time of immunization with hepatitis B and tetanus toxoid (TT) vaccines impacts an individual’s ability to achieve and maintain protective antibody levels against hepatitis B surface antigen or TT.MethodsAdults were recruited from Kisumu Polytechnic College in Western Kenya. At enrollment, participants were screened for schistosomiasis and soil transmitted helminths (STHs) and assigned to groups based on helminth status. The vaccines were then administered and helminth infections treated a week after the first hepatitis B boost. Over an 8 month period, 3 blood specimens were obtained for the evaluation of humoral and cytokine responses to the vaccine antigens and for immunophenotyping.Results146 individuals were available for final analysis and 26% were S. mansoni positive (Sm+). Schistosomiasis did not impede the generation of initial minimum protective antibody levels to either hepatitis B or TT vaccines. However, median hepatitis B surface antibody levels were significantly lower in the Sm+ group after the first boost and remained lower, but not significantly lower, following praziquantel (PZQ) treatment and final boost. In addition, 8 months following TT boost and 7 months following PZQ treatment, Sm+ individuals were more likely to have anti-TT antibody levels fall below levels considered optimal for long term protection. IL-5 levels in response to in vitro TT stimulation of whole blood were significantly higher in the Sm+ group at the 8 month time period as well.ConclusionsIndividuals with schistosomiasis at the start the immunizations were capable of responding appropriately to the vaccines as measured by antibody responses. However, they may be at risk of a more rapid decline in antibody levels over time, suggesting that treating schistosome infections with praziquantel before immunizations could be beneficial. The timing of the treatment as well as its full impact on the maintenance of antibodies against vaccine antigens remains to be elucidated.

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Chronic hepatitis B and liver schistosomiasis: a deleterious association

Abstract: The association between replicative CHB and schistosomal PF can be a risk factor for more severe liver disease, which can result in deleterious outcomes for patients from endemic areas.

Cited by 17 publications

References 36 publications

Hepatitis B and Schistosoma co-infection in a non-endemic area

Hepatitis B and Schistosoma co-infection in a non-endemic area

Schistosomiasis, hepatitis B and hepatitis C co-infection

Schistosoma mansoni Infection Can Jeopardize the Duration of Protective Levels of Antibody Responses to Immunizations against Hepatitis B and Tetanus Toxoid

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