TREATMENT OF HUMAN CHRONIC FASCIOLIASIS WITH TRICLABENDAZOLE - DRUG EFFICACY AND SEROLOGIC RESPONSE

Between November 1990 and March 1992, 24 asymptomatic individuals in C hile with chronic hepatic fascioliasis confirmed by the presence of Fa sciola hepatica eggs in feces were treated with a single oral dose of triclabendazole (10 mg/kg of body weight) after an overnight fast. Nin eteen (79.2%) of 24 patients were egg-negative two months after treatm ent. Three of five cases with F. hepatica in feces after the first tre atment were retreated and parasitologic cure was achieved. Tolerance t o the drug was excellent; none of the patients had either secondary sy mptoms or important alterations in levels of aspartate and amino trans ferases, alkaline phosphatase, or bilirubin during or after treatment. Mild eosinophilia, present in 70% of the cases, persisted at least un til 60 days after treatment. An enzyme-linked immunosorbent assay (ELI SA) was highly effective in diagnosis and post-treatment monitoring. B efore treatment, 20 (83.3%) of 24 confirmed cases had positive test re sults. The test results became negative by the second month of treatme nt in 40% of the cured cases. This percentage increased progressively, reaching 91.3% at 12 months after therapy. In the five cases in which treatment failed, the ELISA results remained positive until the end o f the follow-up period (six months). In three of these cases who accep ted a second round of therapy with triclabendazole six months after th e first treatment, the ELISA results became negative in all three six months after parasitologic cure and remained negative until the end of the period. Due to its efficacy, excellent tolerance, and ease of adm inistration (a single oral dose), triclabendazole appears to be the dr ug of choice for chronic human fascioliasis.