Biochemical changes in patients with combined chronic schistosomiasis and viral hepatitis C infections

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.