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Afrifa J, Ofori EG, Opoku YK, Asare KK, Sorkpor RD, Naveh-Fio IW, Armah R, Ofori S, Ephraim RKD. Oxidative Stress and Cancer Risk in Schistosomiasis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2024; 2024:9701021. [PMID: 39720557 PMCID: PMC11668550 DOI: 10.1155/omcl/9701021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 11/27/2024] [Indexed: 12/26/2024]
Abstract
Background: Schistosomiasis is considered one of the most devastating parasitic diseases globally, coming second only to malaria in terms of morbidity. The disease-causing parasite can inhabit the body for over a decade, leading to imbalances in the host's metabolic systems. The flukes and their eggs can illicit various immunological and metabolic complications resulting in the generation of reactive oxygen species (ROS). These are known to have several devastating effects on the host through increased oxidative stress, DNA mutation, and gene modifications, which can lead to fibrosis and cancer. Main Body: Here, we discuss oxidative stress and cancer risk in Schistosoma infection. The concept of ROS generation and the complex antioxidant systems that enable the parasite to evade oxidant insults and prolong its life span in the host are explored. Further, the various roles of ROS during the initiation and progression of schistosomiasis and its influence on the host are discussed. Finally, mechanisms linked to the risk of bladder cancer in Schistosoma haematobium (S. haematobium) infections are elucidated. Conclusion: Finally, we provide an opinion on how some of these mechanisms could give directions for future studies as well as provide a springboard for diagnostics and drug targeting in schistosomiasis.
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Affiliation(s)
- Justice Afrifa
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Eric Gyamerah Ofori
- Department of Biology Education, Faculty of Science Education, University of Education, Winneba, Ghana
| | - Yeboah Kwaku Opoku
- Department of Biology Education, Faculty of Science Education, University of Education, Winneba, Ghana
| | - Kwame Kumi Asare
- Infectious and Non-Communicable Diseases, Biomedical and Clinical Research Centre, University of Cape Coast, Cape Coast, Ghana
| | - Rosemary Doe Sorkpor
- Inspectorate Directorate, Food and Drugs Authority, Cape Coast P.O. Box CC13733, Ghana
| | - Ibrahim W. Naveh-Fio
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Richard Armah
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Sandra Ofori
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Richard K. D. Ephraim
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
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Allam AF, Farag HF, Shehab AY, El Sahy AS, Khalil SS, El-Latif NFA. Schistosoma mansoni infection and hepatocellular carcinoma: a comorbidity study. J Parasit Dis 2024; 48:936-943. [PMID: 39493486 PMCID: PMC11528082 DOI: 10.1007/s12639-024-01721-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 07/31/2024] [Indexed: 11/05/2024] Open
Abstract
Background The implication of human Schistosoma mansoni (S. mansoni) infection in concomitance with other risk factors such as hepatitis C virus (HCV) and hepatitis B virus (HBV) in the development of hepatocellular carcinoma (HCC) is still under controversy. This work aimed. to evaluate the role of S. mansoni infection in association with hepatitis B virus (HBV), hepatitis C virus (HCV) and other risk factors in the development and/or progress of HCC. Methods The present study was carried out on 90 HCC patients recruited from Kafr El-Sheikh Liver Disease Research Institute. After obtaining their informed consents, socio-demographic and clinical data were collected and patients were examined for S. mansoni by Kato-Katz and indirect hemagglutination (IHA) techniques. Alpha-fetoprotein (AFP) level was determined. The Child-Pugh scoring system and Barcelona Clinic Liver Cancer (BCLC) staging system were used to evaluate the pathological features of the studied patients. Results All participants were negative for active S. mansoni by Kato-Katz. Based on IHA, the participants were categorized into two groups: group I: sixty-two patients negative for S. mansoni and group II: twenty-eight schistosomiasis positive. The patients' age ranged between 40->60, HCC was more prevalent in the age range of > 50-60 years in both groups. Males were more than females and rural participants were more than urban patients in both groups. Most of the patients (88.9%) had HCV while 7.8% had HBV. A higher proportion of HCC patients showed concomitant HCV and S. mansoni (92.6%) than the S. mansoni negative group. The frequency of upper gastrointestinal bleeding (GIB) was four-fold higher among HCC patients positive for schistosomiasis compared to negative schistosomiasis cases (64% vs. 16%). Alpha-fetoprotein (AFP) level was higher in group II than that in group I with no significant difference. Statistical analysis showed no difference between the two studied groups regarding Child scores. On the contrary, BCLC class D was significantly higher among HCC positive schistosomiasis cases compared to the negative group. Conclusion Concomitant S. mansoni with HCV and HBV potentiate HCC progression.
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Affiliation(s)
- Amal Farahat Allam
- Department of Parasitology, Medical Research Institute, University of Alexandria, 165 El Horreya avenue, El Hadara, Alexandria, Egypt
| | - Hoda Fahmy Farag
- Department of Parasitology, Medical Research Institute, University of Alexandria, 165 El Horreya avenue, El Hadara, Alexandria, Egypt
| | - Amel Youssef Shehab
- Department of Parasitology, Medical Research Institute, University of Alexandria, 165 El Horreya avenue, El Hadara, Alexandria, Egypt
| | - Ahmed Soliman El Sahy
- Department of Parasitology, Medical Research Institute, University of Alexandria, 165 El Horreya avenue, El Hadara, Alexandria, Egypt
| | - Safia Saleh Khalil
- Department of Parasitology, Medical Research Institute, University of Alexandria, 165 El Horreya avenue, El Hadara, Alexandria, Egypt
| | - Naglaa Fathi Abd El-Latif
- Department of Parasitology, Medical Research Institute, University of Alexandria, 165 El Horreya avenue, El Hadara, Alexandria, Egypt
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3
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Jain S. Is Schistosoma mansoni playing a part in liver carcinogenesis? J Helminthol 2024; 98:e61. [PMID: 39469749 DOI: 10.1017/s0022149x24000506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2024]
Abstract
The relationship between Schistosoma mansoni (Sm) and hepatocellular carcinoma (HCC) has been evaluated by many studies that point towards a co-relation between schistosomal infection and HCC. While many such studies demonstrated that Sm infection in the presence of another carcinogenic factors leads to HCC, none of these studies could conclusively prove the cancer-inducing ability of Sm in humans, independent of other carcinogenic factors. The aim of this work is to present the current understanding on the association of Sm with HCC. Many epidemiological, pathological, and clinical studies have shown the role of multiple events like chronic inflammation and fibrosis as well as hepato-toxic agents like soluble egg antigens (SEAs), which help in creating a micro-environment which is suitable for HCC development. The role of Sm infection and deposited eggs in causing persistent inflammation, advanced fibrosis, and the role of SEAs, especially IPSE/alpha-1, is emphasised. This work concludes that Sm infection has the potential to induce cancer independently but the same has not been reported in humans to date. Extensive research is required to establish a causal relationship between Sm infection and HCC induction, or a complete lack thereof. However, Sm infection definitely acts along with other carcinogenic factors to induce HCC at a much faster pace and also leads to an aggressive form of liver cancer, which the other carcinogenic factor could not have achieved alone.
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Affiliation(s)
- S Jain
- Institute for Globally Distributed Open Research and Education (IGDORE), India
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Makhlouf NA, Abu-Elfatth A, Khaled T, El-Kassas M. The Interplay Between Schistosomiasis and Hepatitis C Virus: Battling on Two Fronts. INFECTIOUS DISEASES & IMMUNITY 2024; 4:187-193. [DOI: 10.1097/id9.0000000000000137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Indexed: 01/04/2025]
Abstract
Abstract
Schistosomiasis is a prevalent health issue in numerous countries in Africa, Asia, and South America. Data regarding the coinfection of schistosomiasis with hepatitis C virus (HCV) is limited, yet this coinfection is prevalent in regions where schistosomiasis is endemic. The extent of the coinfection issue is evident in countries with a high prevalence of both diseases, such as Egypt. Coinfections with schistosomiasis result in more pronounced liver damage compared with an HCV infection alone. Schistosomiasis has been found to disrupt HCV-specific T-cell responses, resulting in high viral load, increased likelihood of HCV chronicity, and accelerated development of comorbidities in individuals with coinfection. Introducing new, directly acting antivirals for HCV treatment resulted in a marked shift in the disease landscape. This shift may have an impact on the incidence of coinfection with schistosomiasis. This review emphasizes the notable influence of schistosomiasis on the vulnerability to HCV coinfection, the gravity of the consequent liver pathology, and the effectiveness of HCV antiviral therapy.
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Affiliation(s)
- Nahed A Makhlouf
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Ahmed Abu-Elfatth
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
- Department of Gastroenterology and Hepatology, Aljazeera Hospital, Riyadh 14236, Saudi Arabia
| | - Tasneem Khaled
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Mohamed El-Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo 11795, Egypt
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh 11411, Saudi Arabia
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El-Kassas M, Sheemy RE, Elbadry M. Strategies and achievements in controlling and eliminating schistosomiasis from Egypt. EGYPTIAN LIVER JOURNAL 2024; 14:31. [DOI: 10.1186/s43066-024-00339-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 04/28/2024] [Indexed: 01/04/2025] Open
Abstract
AbstractSchistosomiasis is an old parasitic disease in Egypt primarily caused by Schistosoma mansoni, transmitted through infected water canals, and disproportionately affects rural areas. Despite substantial reductions in the disease prevalence over the years, it still affects more than 5% of the population in some governorates, highlighting the need for sustained control efforts. Among the recent control measures: (a) mass drug administration with large-scale, biannual administration of praziquantel, which remains the cornerstone of the control program targeting the interruption of vector transmission cycles. (b) Improving disease diagnostics, including point-of-care tests, which facilitate early detection and case management, particularly in remote areas. (c) Snail control using targeted mollusciciding aims to reduce parasite transmission by controlling intermediate snail hosts. And (d) behavioral change communication focusing on raising awareness regarding hygiene practices and safe water access.Even if control attempts have shown positive results, several challenges still exist, including (a) drug resistance, especially to praziquantel, the most commonly used drug, which calls for ongoing observation and monitoring. (b) Sustainability of funding to avoid program disruptions and setbacks. And (c) social and environmental factors like poverty, poor sanitation, and access to clean water. The transition from disease control to elimination requires meticulous planning and vigilance. Robust surveillance systems, enhanced case management, and continued community engagement are vital for such elimination. Strengthening research on drug resistance, snail control methods, and innovative diagnostics would further support elimination efforts. This report aims to address the most recent data regarding the prevalence and control measures for schistosomiasis in Egypt and provide the information required to lead the transition from disease control to elimination.
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Jain S, Rana M. From the discovery of helminths to the discovery of their carcinogenic potential. Parasitol Res 2023; 123:47. [PMID: 38095695 DOI: 10.1007/s00436-023-08022-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023]
Abstract
Cancer involves a major aberration in the normal behaviour of cells, making them divide continuously, which interferes with the normal physiology of the body. The link between helminths and their cancer-inducing potential has been proposed in the last century. The exact pathway is still not clear but chronic inflammation in response to the deposited eggs, immune response against soluble egg antigens, and co-infection with a third party (a bacteria, a virus, or infection leading to a change in microbiome) seems to be the reasons for cancer induction. This review looks into the historical outlook on helminths along with their epidemiology, morphology, and life cycle. It then focuses on providing correlations between helminth infection and molecular mechanism of carcinogenesis by elaborating upon epidemiological, clinical, and surgical studies. While the cancer-inducing potential has been convincingly established only for a few helminths and studies point out towards possible cancer-inducing ability of the rest of the helminths elucidated in this work, however, more insights into the immunobiology of helminths as well as infected patients are required to conclusively comment upon this ability of the latter.
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Affiliation(s)
- Sidhant Jain
- Institute for Globally Distributed Open Research and Education (IGDORE), Rewari, Haryana, India.
| | - Meenakshi Rana
- Dyal Singh College, University of Delhi, Lodhi Road, Pragati Vihaar, New Delhi, India
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Liu XF, Ju S, Wang KY, Li Y, Qiang JW. The prevalence rate, mortality, and 5-year overall survival of Schistosoma japonicum patients with human malignancy. Front Oncol 2023; 13:1288197. [PMID: 38125940 PMCID: PMC10731309 DOI: 10.3389/fonc.2023.1288197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Background Only a few studies have focused on the association between Schistosoma japonicum and human malignancy. The aim of this study was to update the prevalence rate, mortality, and 5-year overall survival of S. japonicum patients with human malignancy. Methods From January 20, 2018, to January 31, 2021, 5,866 inpatients were included in the study. A total of 656 S. japonicum patients with malignancy were identified. Cases were stratified by gender and age groups. The cancer sites, prevalence rate, mortality, and 5-year overall survival of the patients were reported. The S. japonicum patients with malignancy were further divided into a non-digestive system tumor group (n = 309) and a digestive system tumor group (n = 347), including those with cancer in the esophagus, stomach, colon, rectum, liver, gallbladder, bile duct, or pancreas. Chi-squared test and odds ratio with confidence intervals were performed between these two groups. Results Lung cancer was found the most common malignancy, accounting for 18.6% of all malignancies, followed by colorectal, stomach, liver, and gallbladder cancers. These five leading malignancies accounted for approximately 61.8% of all cases. Colorectal cancer was the leading cause of malignancy death, followed by lung, stomach, gallbladder, and liver cancers. These five leading causes of death accounted for approximately 55.6% of all death cases. Statistical significance was found in the prevalence rate between S. japonicum and non-S. japonicum patients with/without digestive system tumor (p < 0.001). The odds ratio of S. japonicum patients with digestive system tumors was 1.6 (95%CI: 1.4-1.9). Conclusion S. japonicum contributes to a significant prevalence and mortality in digestive system tumors, including colorectal, stomach, liver, and gallbladder cancers.
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Affiliation(s)
- Xue-Fei Liu
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Shuai Ju
- Departments of Interventional Radiology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Ke-Ying Wang
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Ying Li
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Jin-Wei Qiang
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China
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8
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Darce GFB, Makdissi FF, Ando SDM, Fonseca GM, Kruger JAP, Coelho FF, Rocha MDS, Herman P. HEPATOSPLENIC SCHISTOSOMIASIS-ASSOCIATED CHRONIC PORTAL VEIN THROMBOSIS: RISK FACTOR FOR HEPATOCELLULAR CARCINOMA? ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2023; 36:e1763. [PMID: 37729278 PMCID: PMC10510374 DOI: 10.1590/0102-672020230045e1763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 07/20/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Hepatosplenic schistosomiasis is an endemic disease prevalent in tropical countries and is associated with a high incidence of portal vein thrombosis. Inflammatory changes caused by both parasitic infection and portal thrombosis can lead to the development of chronic liver disease with potential carcinogenesis. AIMS To assess the incidence of portal vein thrombosis and hepatocellular carcinoma in patients with schistosomiasis during long-term follow-up. METHODS A retrospective study was conducted involving patients with schistosomiasis followed up at our institution between 1990 and 2021. RESULTS A total of 126 patients with schistosomiasis were evaluated in the study. The mean follow-up time was 16 years (range 5-31). Of the total, 73 (57.9%) patients presented portal vein thrombosis during follow-up. Six (8.1%) of them were diagnosed with hepatocellular carcinoma, all with portal vein thrombosis diagnosed more than ten years before. CONCLUSIONS The incidence of hepatocellular carcinoma in patients with schistosomiasis and chronic portal vein thrombosis highlights the importance of a systematic long-term follow-up in this group of patients.
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Affiliation(s)
| | - Fabio Ferrari Makdissi
- Universidade de São Paulo, Faculty of Medicine, Cancer Institute – São Paulo (SP), Brazil
| | - Sabrina de Mello Ando
- Universidade de São Paulo, Falculty of Medicine, Department of Radiology –São Paulo (SP), Brazil
| | - Gilton Marques Fonseca
- Universidade de São Paulo, Falculty of Medicine, Department of Gastroenterology – São Paulo (SP), Brazil
| | | | - Fabricio Ferreira Coelho
- Universidade de São Paulo, Falculty of Medicine, Department of Gastroenterology – São Paulo (SP), Brazil
| | - Manoel de Souza Rocha
- Universidade de São Paulo, Falculty of Medicine, Department of Radiology –São Paulo (SP), Brazil
| | - Paulo Herman
- Universidade de São Paulo, Falculty of Medicine, Department of Gastroenterology – São Paulo (SP), Brazil
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Walker PF, Settgast AM, DeSilva MB. Cancer Screening in Refugees and Immigrants: A Global Perspective. Am J Trop Med Hyg 2022; 106:tpmd210692. [PMID: 35533696 PMCID: PMC9209943 DOI: 10.4269/ajtmh.21-0692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 02/09/2022] [Indexed: 12/24/2022] Open
Abstract
Clinicians in the United States are trained to screen for cancer based on patient age, gender, family history, and environmental risk factors such as smoking. These cancers generally include, breast, cervical, colon, lung, and prostate cancers. We know that refugees and other immigrants to the United States experience dramatic disparities in cancer screening. Additionally, many immigrants experience elevated risks from infection-attributable cancers due to their country or region of origin. U.S.- based clinicians may not routinely consider these unique risk factors. Although this article focuses on refugees, it is also intended to guide clinicians caring for other foreign-born immigrant groups living in the United States (hereafter referred to as "immigrants"). The document contains two sections: 1) special considerations for U.S. Preventive Services Task Force guidelines cancer screening recommendations in immigrants and 2) cancer risks and screening recommendation unique to certain immigrant groups. Disparities in cancer screening and prevalence are often greater for specific immigrant groups than for broader racial or ethnic groups (e.g., Black, Asian, Hispanic) into which they may fit. Disaggregation of data by language or country of origin is useful to identify such disparities and to design intervention opportunities within specific communities that are culturally distinct and/or who have different environmental exposures. Unique cancer risks and disparities in screening support a nuanced approach to cancer screening for immigrant and refugee populations, which is the focus of this narrative review.
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Affiliation(s)
- Patricia F. Walker
- HealthPartners Institute, Bloomington, Minnesota
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
- HealthPartners Travel and Tropical Medicine Center, St. Paul, Minnesota
| | - Ann M. Settgast
- HealthPartners Institute, Bloomington, Minnesota
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
- HealthPartners Center for International Health, St. Paul, Minnesota
- HealthPartners Travel and Tropical Medicine Center, St. Paul, Minnesota
| | - Malini B. DeSilva
- HealthPartners Institute, Bloomington, Minnesota
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
- HealthPartners Travel and Tropical Medicine Center, St. Paul, Minnesota
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Shousha HI, Abdelaziz AO, Nabeel MM, Omran DA, Abdelmaksoud AH, Elbaz TM, Salah A, Harb STE, Hosny KA, Osman A, Atef M, Gaber A, Zayed NA, Yosry AA, Leithy R. Schistosoma mansoni infection and the occurrence, characteristics, and survival of patients with hepatocellular carcinoma: an observational study over a decade. Pathog Glob Health 2022; 116:119-127. [PMID: 34494507 PMCID: PMC8933024 DOI: 10.1080/20477724.2021.1975081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Schistosoma mansoni infection (SMI) is suspected to be directly and indirectly involved in hepato-carcinogenesis. This study evaluated the association of a previous SMI with hepatocellular carcinoma (HCC) development, patients, tumor characteristics, treatment outcomes, and survival. This observational study included patients with HCC with and without previous SMI who presented to the multidisciplinary HCC clinic, Kasr-Alainy hospital (November 2009 to December 2019). It also included 313 patients with liver cirrhosis without HCC. Clinical and laboratory features of the patients (complete blood count, liver/renal functions , alpha-fetoprotein, and hepatitis B/C status), tumor characteristics (Triphasic CT and/or dynamic MRI), liver stiffness (transient elastography), HCC treatment outcome, and overall survival were studied. This study included 1446 patients with HCC; 688(47.6%) composed group-1, defined by patients having a history of SMI, and 758(52.4%) were in group-2 and without history of SMI. Male sex, smoking, diabetes mellitus, splenomegaly, deteriorated performance status, synthetic liver functions, and platelet count were significantly higher in group-1. The groups did not differ with regard to liver stiffness, tumor characteristics, or the occurrence of post-HCC treatment hepatic decompensation or recurrence. HCC treatment response was better in group-2. Group-1 showed lower sustained virological response to hepatitis C direct-acting antivirals (DAAs) compared with group-2 (60% versus 84.3%, respectively, P = 0.027). Prior SMI was associated with HCC (adjusted odds ratio = 1.589, 95% confidence interval = 1.187-2.127), and it was concluded that it increases the risk of HCC. In addition, it significantly affects the performance status, laboratory characteristics, response to DAAs, and overall survival.
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Affiliation(s)
- Hend Ibrahim Shousha
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ashraf Omar Abdelaziz
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Mahmoud Nabeel
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia Abdelhamid Omran
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Hosni Abdelmaksoud
- Diagnostic and Interventional Radiology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tamer Mahmoud Elbaz
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman Salah
- General Surgery Department, Liver Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Karim Adel Hosny
- General Surgery Department, Liver Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman Osman
- General Surgery Department, Liver Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mira Atef
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Abdelazez Gaber
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Naglaa Ali Zayed
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman Abdelhady Yosry
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rania Leithy
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Abd El-Wahab EW, Abd Elgawad WM, Said M, Mikheal AI, Shatat HZ. Liver Disease Outcomes after Sustained Virological Response in Patients with Chronic Hepatitis C Infection Treated with Generic Direct-Acting Antivirals. Am J Trop Med Hyg 2022; 106:tpmd210918. [PMID: 35226870 PMCID: PMC9128674 DOI: 10.4269/ajtmh.21-0918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 12/22/2021] [Indexed: 11/07/2022] Open
Abstract
The introduction of generic direct-acting antivirals (DAAs) in Egypt is associated with a superior cure rate of hepatitis C virus (HCV) infection. However, the course of progressive liver damage and developing liver related complications in patients with sustained virologic response (SVR) remain unclear. This study was designed to examine the long-term outcomes of generic DAA-induced virological cure in a real-life cohort of HCV patients with or without comorbid schistosomiasis. We prospectively enrolled a cohort of 506 recently cured HCV patients (437 Child-Pugh class A [Child-A] and 69 Child-Pugh class B [Child-B]). All patients were clinically evaluated at different time points during a 2-year follow-up (November 2018 to February 2021). Over the course of treatment and follow-up, 77 (15.2%) patients (42 [9.6%] Child-A and 35 [50.7%] Child-B) experienced complications at different time points. The overall mortality rate was approximately 1/1,000 person-years. The incidence of hepatic insufficiency was approximately 5.5/1,000 person-years, and that of de novo hepatocellular carcinoma (HCC) was approximately 8.3/1,000 person-years. A sustained improvement in liver indices up to 2 years of follow-up was observed. In the Cox regression model, pretreatment decompensated cirrhosis predicted the occurrence of adverse liver events and HCC after therapy. In conclusion, in HCV patients with advanced cirrhosis or coexisting hepatic schistosomiasis, generic DAA-induced SVR remains robust with favorable clinical outcomes although the risk of hepatocarcinogenesis cannot be eliminated. Surveillance of patients with treated HCV infection is an important aspect of postcure care for early detection and management of liver disease-related adverse events.
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Affiliation(s)
- Ekram W. Abd El-Wahab
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Waleed M. Abd Elgawad
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
- Department of Endemic and Infectious Diseases, Damanhour Fever Hospital, Ministry of Health and Population, Damanhour, Egypt
| | - Mohamed Said
- Endemic Medicine and Hepatogastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ashraf I. Mikheal
- Department of Endemic and Infectious Diseases, Damanhour Fever Hospital, Ministry of Health and Population, Damanhour, Egypt
| | - Hanan Z. Shatat
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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von Bülow V, Lichtenberger J, Grevelding CG, Falcone FH, Roeb E, Roderfeld M. Does Schistosoma Mansoni Facilitate Carcinogenesis? Cells 2021; 10:1982. [PMID: 34440754 PMCID: PMC8393187 DOI: 10.3390/cells10081982] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/21/2021] [Accepted: 08/01/2021] [Indexed: 12/24/2022] Open
Abstract
Schistosomiasis is one of the most prominent parasite-induced infectious diseases, causing tremendous medical and socioeconomic problems. Current studies have reported on the spread of endemic regions and the fear of development of resistance against praziquantel, the only effective drug available. Among the Schistosoma species, only S. haematobium is classified as a Group 1 carcinogen (definitely cancerogenic to humans), causing squamous cell carcinoma of the bladder, whereas infection with S. mansoni is included in Group 3 of carcinogenic hazards to humans by the International Agency for Research on Cancer (IARC), indicating insufficient evidence to determine its carcinogenicity. Nevertheless, although S. mansoni has not been discussed as an organic carcinogen, the multiplicity of case reports, together with recent data from animal models and cell culture experiments, suggests that this parasite can predispose patients to or promote hepatic and colorectal cancer. In this review, we discuss the current data, with a focus on new developments regarding the association of S. mansoni infection with human cancer and the recently discovered biomolecular mechanisms by which S. mansoni may predispose patients to cancer development and carcinogenesis.
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Affiliation(s)
- Verena von Bülow
- Department of Gastroenterology, Justus Liebig University, 35392 Giessen, Germany; (V.v.B.); (J.L.); (E.R.)
| | - Jakob Lichtenberger
- Department of Gastroenterology, Justus Liebig University, 35392 Giessen, Germany; (V.v.B.); (J.L.); (E.R.)
| | - Christoph G. Grevelding
- Institute of Parasitology, BFS, Justus Liebig University, 35392 Giessen, Germany; (C.G.G.); (F.H.F.)
| | - Franco H. Falcone
- Institute of Parasitology, BFS, Justus Liebig University, 35392 Giessen, Germany; (C.G.G.); (F.H.F.)
| | - Elke Roeb
- Department of Gastroenterology, Justus Liebig University, 35392 Giessen, Germany; (V.v.B.); (J.L.); (E.R.)
| | - Martin Roderfeld
- Department of Gastroenterology, Justus Liebig University, 35392 Giessen, Germany; (V.v.B.); (J.L.); (E.R.)
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Saharti S, Ding X, Massarani-Wafai R, Pambuccian SE. Fine-needle aspirate of the liver showing coexistence of Schistosoma japonicum ova and hepatocellular carcinoma. Diagn Cytopathol 2019; 46:716-720. [PMID: 31012546 DOI: 10.1002/dc.23969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 04/17/2018] [Accepted: 04/27/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Samah Saharti
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
| | - Xianzhong Ding
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
| | | | - Stefan E Pambuccian
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
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Abdelmoez FAB, Imam HM, Idriss NK, Wahid LA, Abbas WA, Abozaid MAA, Abdelwahab HM. The Role of Hepatitis C virus and Possible Risk factors in development of Hepatocellular carcinoma: 400 Patients based study. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2019. [DOI: 10.4103/ejim.ejim_50_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Nepal P, Ojili V, Songmen S, Batchala P, Kumar D, Nagar AM. Multisystem imaging review of human schistosomiasis: characteristic imaging findings. Clin Imaging 2019; 54:163-171. [DOI: 10.1016/j.clinimag.2019.01.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/07/2019] [Accepted: 01/15/2019] [Indexed: 12/14/2022]
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Schistosomal liver fibrosis and hepatocellular carcinoma - case series of patients submitted to liver transplantation. Braz J Infect Dis 2018; 22:352-354. [PMID: 30017854 PMCID: PMC9427810 DOI: 10.1016/j.bjid.2018.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/08/2018] [Accepted: 06/12/2018] [Indexed: 02/04/2023] Open
Abstract
Schistosomiasis affects approximately 207 million people in 76 countries. The association between hepatocellular carcinoma and Schistosoma mansoni infection has been investigated. Studies using animal models suggest that the parasite may accelerate the oncogenic process when combined with other factors, such as hepatitis C virus infection or exposure to a carcinogen. Herein, we report a case series of six hepatocellular carcinoma patients from Northeast Brazil, with negative serology for both hepatitis B and C virus, submitted to liver transplantation, whose explant showed evidence of schistosomal liver fibrosis. Since all patients enrolled in this study were submitted to liver transplantation, we were able to access the whole explanted liver and perform histopathological analysis, which is often not possible in other situations. Although 50% of them showed signs of liver failure, no cirrhosis or any liver disease other than schistosomal fibrosis had been detected. These uncommon findings suggest that Schistosoma mansoni infection might predispose to hepatocellular carcinoma development, regardless of the absence of other risk factors.
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Epigastric Pain in a Patient with Cirrhosis. J Clin Exp Hepatol 2017; 7:161-162. [PMID: 28663683 PMCID: PMC5478939 DOI: 10.1016/j.jceh.2016.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 09/28/2016] [Indexed: 12/12/2022] Open
Abstract
•Classic images of Schistosomiasis.•Pathology proved case.•Impressive educational case.
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