Fa. Fahim et al., Biochemical changes in patients with combined chronic schistosomiasis and viral hepatitis C infections, DIS MARKER, 16(3-4), 2000, pp. 111-118
This study was undertaken to assess the biochemical changes induced in chro
nic schistosomiasis and/or chronic HCV, as well as to pinpoint the most sig
nificant parameters which could be used as dependable indices for the diffe
rentiation of single and coupled infections with or without liver cirrhosis
. The selected patients were allocated into 2 broad groups: GrII (Schistoso
miasis) which was subdivided into 3 subgroups: GrII(a) schistosomal patient
s with hepatosplenomegaly; GrII(b) hepatosplenic schistosomal patients with
decompensated liver cirrhosis; GrII(c) schistosomal patients with no organ
omegaly. Grill (Combined) comprised 2 subgroups: GrIII(a) schistosomal-HCV
infection with decompensated liver cirrhosis; GrIII(b) schistosomal-HCV inf
ection without liver cirrhosis. For statistical comparison normal healthy s
ubjects were taken as a reference group (Gr I). Results showed that schisto
somal patients without organomegaly manifested non significant changes in a
ll studied parameters compared to normal controls. Highly significant eleva
tions in serum ALT, AST, ALP and GGT activities were recorded in all other
subgroups but the highest levels are reported in GrIIb. AST/ALT and direct/
indirect bilirubin ratios were highest in GrIIIa (1.17 +/- 0.26, 1.54 +/- 0
.37, respectively). Serum total protein and albumin levels showed the highe
st reduction (33 and 59%) concomitantly with the highest increase in gamma
-globulin level (75%) in GrIII(a). Blood total iron was significantly reduc
ed in GrII(a,b) (15.6 and 12 %), while it was paradoxically increased in Gr
III(a) (8.8%). One-way ANOVA test revealed that ALP, ALT, total protein, bi
lirubin, GGT and AST in this order are good discriminators between the diff
erent subgroups in GrII. On the other hand, ALT, AST, albumin, ALP, GGT, pr
otein and direct bilirubin are the most significant indices to differentiat
e chronic schistosomiasis and the combined group with/or without liver cirr
hosis.