title: Clonorchis sinensis Co-infection Could Affect the Disease State and Treatment Response of HBV Patients.
abstract: Clonorchis sinensis (C. sinensis) is considered to be an important parasitic zoonosis because it infects approximately 35 million people, while approximately 15 million were distributed in China. Hepatitis B virus (HBV) infection is a major public health issue. Two types of pathogens have the potential to cause human liver disease and eventually hepatocellular carcinoma. Concurrent infection with HBV and C. sinensis is often observed in some areas where C. sinensis is endemic. However, whether C. sinensis could impact HBV infection or vice versa remains unknown.
  
  
  
  Co-infection with C. sinensis and HBV develops predominantly in males. Co-infected C. sinensis and HBV patients presented weaker liver function and higher HBV DNA titers. Combination treatment with antiviral and anti-C. sinensis drugs in co-infected patients could contribute to a reduction in viral load and help with liver function recovery. Excretory-secretory products (ESPs) may, in some ways, increase HBV viral replication in vitro. A mixture of ESP and HBV positive sera could induce peripheral blood mononuclear cells (PBMCs) to produce higher level of Th2 cytokines including IL-4, IL-6 and IL-10 compared to HBV alone, it seems that due to presence of ESP, the cytokine production shift towards Th2. C. sinensis/HBV co-infected patients showed higher serum IL-6 and IL-10 levels and lower serum IFN-γ levels.
  
  
  
  Patients with concomitant C. sinensis and HBV infection presented weaker liver function and higher HBV DNA copies. In co-infected patients, the efficacy of anti-viral treatment was better in patients who were prescribed with entecavir and praziquantel than entecavir alone. One possible reason for the weaker response to antiviral therapies in co-infected patients was the shift in cytokine production from Th1 to Th2 that may inhibit viral clearance. C. sinensis/HBV co-infection could exacerbate the imbalance of Th1/Th2 cytokine.
authors.affiliation: Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China.|Key Laboratory for Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, Guangdong, China.
authors.forename: Wenfang
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China.|Key Laboratory for Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, Guangdong, China.|Department of Clinical Laboratory, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
authors.forename: Huimin
authors.initials: H
authors.lastname: Dong
authors.affiliation: Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China.|Key Laboratory for Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, Guangdong, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China.|Key Laboratory for Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, Guangdong, China.
authors.forename: Tingjin
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China.|Key Laboratory for Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, Guangdong, China.
authors.forename: Xiangzhan
authors.initials: X
authors.lastname: Kong
authors.affiliation: Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China.|Key Laboratory for Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, Guangdong, China.
authors.forename: Hengchang
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China.|Key Laboratory for Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, Guangdong, China.
authors.forename: Xinbing
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China.|Key Laboratory for Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, Guangdong, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Xu
mesh_terms: D000328:Adult; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016022:Case-Control Studies; D002681:China; D003003:Clonorchiasis / Q000150:complications* / Q000188:drug therapy; D003004:Clonorchis sinensis; D060085:Coinfection; D016207:Cytokines / Q000235:genetics / Q000378:metabolism; D004279:DNA, Viral; D005260:Female; D005786:Gene Expression Regulation; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy; D017325:Hepatitis B Vaccines; D006801:Humans; D008297:Male; D008875:Middle Aged; D011223:Praziquantel / Q000008:administration & dosage / Q000627:therapeutic use; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism
chemical_list: D000871:Anthelmintics; D000998:Antiviral Agents; D016207:Cytokines; D004279:DNA, Viral; D017325:Hepatitis B Vaccines; D012333:RNA, Messenger; C413685:entecavir; D006147:Guanine; D011223:Praziquantel