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

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Abstract

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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Acknowledgments

We thank Pablo Garrido Fernández, technician in Research Methodology and Biostatistics from FIBAO, for providing invaluable support for the statistical analysis of the data.

We also thank Antonio Rivero, MD-PhD, head of the Department of Infectious Diseases at the Reina Sofía Hospital in Córdoba, its methodological advice

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Authors and Affiliations

  1. Tropical Medicine Unit. Hospital de Poniente, Carretera de Almerimar s/n, El Ejido, Almería, 07400, Spain

    J. Á. Cuenca-Gómez, J. Salas-Coronas, A. B. Lozano-Serrano, M. J. Soriano-Pérez, A. Villarejo-Ordóñez & M. T. Cabezas-Fernández

  2. CEMyRI (Center for the Study of Migration and Intercultural Relations of the University of Almeria, Almeria, Spain

    J. Salas-Coronas & M. T. Cabezas-Fernández

  3. Tropical Medicine Unit, Distrito Poniente, Almería, Spain

    J. Vázquez-Villegas

  4. Digestive Service, Hospital de Poniente, El Ejido, Almería, Spain

    M. Estévez-Escobar

Authors
  1. J. Á. Cuenca-Gómez
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  2. J. Salas-Coronas
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  3. A. B. Lozano-Serrano
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  4. J. Vázquez-Villegas
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  5. M. J. Soriano-Pérez
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  6. M. Estévez-Escobar
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  7. A. Villarejo-Ordóñez
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  8. M. T. Cabezas-Fernández
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Corresponding author

Correspondence to J. Á. Cuenca-Gómez.

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Funding

The authors declare that this paper has not had any funding.

Ethical statement

This study has been conducted within the activities developed by the research group PAIDI CTS 582 of the regional Ministry of Gender, Health, and Social Policy of the Government of Andalusia, and the CEMyRI (Center for the Study of Migration and Intercultural Relations) of the University of Almeria (Spain).

This is a retrospective study. We used the TMU (Tropical Medicine Unit) database (electronic). Data was exported to a new SSPS file. Subjects were anonymously coded, unlinked from any information identifying the source individuals. Although the study was retrospective and no action on patients was involved, the study protocol was nevertheless submitted to the Ethics Committee of the Coordinating Site (Comité de Ética de la Investigación de Almería) for approval. The latter acknowledged the study protocol and formally authorized the study (protocol n° 9/2016 of 16th February, 2016).

Competing interest

The authors declare that they have no competing interests.

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Cuenca-Gómez, J.Á., Salas-Coronas, J., Lozano-Serrano, A.B. et al. Hepatitis B and Schistosoma co-infection in a non-endemic area. Eur J Clin Microbiol Infect Dis 35, 1487–1493 (2016). https://doi.org/10.1007/s10096-016-2689-6

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  • DOI: https://doi.org/10.1007/s10096-016-2689-6

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