ALBENDAZOLE CHEMOTHERAPY FOR HUMAN CYSTIC AND ALVEOLAR ECHINOCOCCOSISIN NORTH-WESTERN CHINA

Human echinococcosis is highly endemic in north-western China; the mai n treatment is by surgery. In this paper, we report the results of che motherapy with albendazole (ABZ), 15-20 mg/kg/d orally, for 30 d with intervals of 10 d between treatments for 3-6 courses. For multi-organ cystic echinococcosis (CE) and alveolar echinococcosis (AE), patients were given 12-18 courses of ABZ. Patients were divided into 4 groups: (i) ABZ surgery group, albendazole with surgery for 21 CE cases: (ii) non-ABZ surgery group, 80 CE cases treated by surgery alone; (iii) ABZ CE group, albendazole treatment alone in 58 CE cases, and (iv) ABZ AE group, 14 AE patients treated by albendazole and surgical interventio n and 5 AE patients treated by albendazole alone. Twenty-seven of 34 ( 79.4%) cysts in group (i) patients showed increased necrotic changes a nd decreased viability of the cysts compared to group (ii). However, 1 0 of 84 (11.9%) cysts in group (ii) patients showed spontaneous eviden ce of necrosis at surgery. In group (iii), ABZ treatment alone was suc cessful in 14 (24.1%), resulted in improvement in 29 (50%) and had no effect in 15 (25.9%) patients. Seven cases in group (iv) improved, wit h diminished size of lesions which were non viable. The remaining 7 ca ses in group (iv) showed evidence of cyst viability at surgery; 2 coul d not be saved after a further 15 courses of albendazole. Of the five AE patients in group (iv) who received only ABZ, one improved, 2 stabi lized, one deteriorated and one died. Albendazole chemotherapy, while not completely effective, has an important role in treatment of both c ystic and alveolar echinococcosis.