Factors controlling the effect of praziquantel on liver fibrosis in Schistosoma mansoni-infected patients.
An association study of a cohort of 177 Sudanese patients infected with Schistosoma mansoni [82 (46%) males and 95 (54%) females] was conducted to evaluate the factors controlling the regression of liver fibrosis 39 months after treatment with praziquantel using ultrasound evaluation. Periportal fibrosis (PPF) was regressed in 63 (35.6%) patients, while the disease progressed to higher grades in 24 (13.6%) patients. The grade of PPF did not change in 90 (50.8%) patients. The mean values of portal vein diameter, splenic vein diameter and index liver size in subjects in whom PPF regressed after treatment were significantly lower than in subjects in whom the disease was progressed (P<0.0001, P=0.031 and P=0.003, respectively). The progression of hepatic fibrosis in males (15, 8.5%) was greater than that in females (9, 5.1%). Patients with regression or progression phenotypes tend to cluster in certain families. Our study indicated that regression, progression and stabilization of PPF after praziquantel therapy is controlled by gender, age, grade of fibrosis and possibly inherited factors.
Rahoud
Siddig A
SA
Center of Biosciences and Biotechnology, University of Gezira, Wad Medani, Sudan. rahoud_ug@yahoo.com
Mergani
Adil
A
Khamis
Ammar H
AH
Saeed
Osman K
OK
Mohamed-Ali
Qurashi
Q
Dessein
Alain J
AJ
Elwali
Nasr Eldin M A
NE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000469:parasitology / Q000473:pathology; D008109:Liver Diseases, Parasitic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000469:parasitology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology; D011223:Praziquantel / Q000008:administration & dosage / Q000627:therapeutic use*; D012550:Schistosoma mansoni / Q000187:drug effects / Q000472:pathogenicity; D012555:Schistosomiasis mansoni / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000469:parasitology; D012737:Sex Factors; D013397:Sudan; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
D000871:Anthelmintics; D011223:Praziquantel