PREVALENCE OF HEPATITIS-B SURFACE ANTIGENEMIA AMONG PATIENTS WITH SCHISTOSOMA-MANSONI

This case-control study was designed to determine the prevalence of pe rsistent hepatitis B surface antigenemia (HBsAG) among patients with s chistosoma mansoni and to rationalize their vaccination against hepati tis B virus (HBV) infection. Seventy consecutive patients with a confi rmed diagnosis of schistosoma mansoni were matched for age, sex, natio nality, and residence (for Saudis only) with 70 healthy controls. Desp ite identical mean ages, sex, and nationality distribution, 18 schisto somiasis patients (26%) had positive HBsAg as compared with only three of the controls (4%). The odd ratio for HBsAg antigenemia among patie nts as compared to controls was 7.73 (95% confidence interval (Cl) = 2 -35.01, P = 0.0004. Neither sex nor nationality had any influence on t he positive rate for HBsAg found in schistosomiasis patients. Patients with schistosomiasis and a concomitant positive HBsAg had significant ly more derangement of their hepatic enzymes (14 out of 18; 78%) as co mpared with those without this viral serological marker (22 out of 52; 42%) (odd ratio - 4.77; 95% Cl = 1.22-20.11; P = 0.009). I have concl uded that patients with schistosoma mansoni are exposed to a higher ri sk of acquiring HBV infection and that concomitant schistosomiasis and HBV infection has a deleterious effect on hepatic enzymes as well as other liver functions. Prospective evaluation of the preventive role o f HBV vaccine among these patients is warranted.