Hepatitis C virus infection in schistosomiasis mansoni in Brazil

Abstract

The involvement of the hepatitis C virus (HCV) in the severity of liver disease in chronic schistosomiasis was investigated in 215 Brazilian patients with S. mansoni infections, but without evidence of hepatitis B surface antigen (HBsAg). Forty-three had hepatointestinal (HIS) and 172 had hepatosplenic schistosomiasis (HSS), and 135 had compensated (HSSC), and 37 had decompensated (HSSD) liver disease. Fifty-two (24%) were found to have evidence of HCV infection (seropositive for anti-HCV antibodies and/or HCV-RNA). These comprised 35 (95%) of the 37 with HSSD, 16 (12%) of the 135 with HSSC, and 1 (2.4%) of the 43 with HIS, compared with only 1 (2%) of 50 control patients without S. mansoni. Testing of matched liver tissue and peripheral blood mononuclear cells (PBMCs) from 25 patients (6 HSSC and 19 HSSD) with HCV infections showed that 17 (68%) had "active" viral infections, in that negative strand HCV-RNA (the presumed replicative intermediate of the virus) could be detected in liver and/or PBMCs. Among these 25, negative strand HCV-RNA was found in 16 (84%) of the 19 with chronic active hepatitis, but in only 1 (17%) of the 6 with mild or inactive disease (P < 0.01). HCV-RNA was detected in matched spleen specimens from 9 of 10 patients (all of whom were also positive in PBMCs), suggesting that the spleen is an important extrahepatic reservoir of the virus.(ABSTRACT TRUNCATED AT 250 WORDS)

Association between Schistosomiasis mansoni and hepatitis C: systematic review

“…2,9,19,29,30 Among the 13 articles included in the fi nal step of the review, ten were cross-sectional studies, 8,9,19,29,30,36,37,39,40,45 one was a retrospective cases series, 6 one was a prospective cases series 2 and the other was a cases series with an external control group. 32 Five studies 6,32,39,40,45 were conducted in Brazil, fi ve in Egypt, 2,9,19,29,30 two in Sudan, 36,37 one in Ethiopia 8 and one in Kenya. 9 A higher prevalence of HCV infection was found in the SM population of Egypt, compared to the other countries (Table 1).…”

“…30 Six studies 6,9,29,37,39,40 aimed to evaluate the severity of hepatic lesions and morbidity of hepatitis C when associated with SM and to correlate this with serologic markers. The mean age of humans enrolled in these studies was 33.7 years and in four articles subjects were > 40 years 6,29,32,36 (Table 2).…”

“…29,40 Concomitant SM and HCV infection is observed with high frequency in Egypt 2,7,47 and Brazil. 39 Hepatitis C is also considered an important public health issue throughout the world, with approximately 3% of people (about 170 million) being infected with the HCV. 1 United Kingdom and USA, 5,41,53,54 and in developing countries, such as Egypt 2,25,26 and Brazil.…”

“…1 United Kingdom and USA, 5,41,53,54 and in developing countries, such as Egypt 2,25,26 and Brazil. 6,39,45 In Egypt, eight to ten million are infected and 68 million people have been exposed to HCV 52 (a prevalence of 10 to 60%), mainly in rural areas. 15,17,21 The prevalence of HCV infection is lower in Brazil than in Egypt and varies from 2.5% to 4.9%, corresponding to approximately 3.9 to 7.6 million people.…”

“…Likewise, an infl uence of SM on HCV severity has been suggested by some authors. 29,33,39 There are many contradictory data about the prevalence of HCV/S. mansoni co-infection in SM endemic areas and the risk factors associated with increased susceptibility for HCV infection in a S. mansoni-infected person, especially in the HS form.…”