Schistosoma mansoni infection and the occurrence, characteristics, and survival of patients with hepatocellular carcinoma: an observational study over a decade.
Hend Ibrahim ShoushaAshraf Omar AbdelazizMohamed Mahmoud NabeelDalia Abdelhamid OmranAhmed Hosni AbdelmaksoudTamer Mahmoud ElbazAyman SalahShady Tarek ElGhazaly HarbKarim Adel HosnyAyman M A OsmanMira AtefAbdelazez GaberNaglaa Ali ZayedAyman Abdelhady YosryRania Mohamed LithyPublished in: Pathogens and global health (2021)
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.
Keyphrases
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- magnetic resonance imaging
- risk assessment
- emergency department
- type diabetes
- healthcare
- adipose tissue
- primary care
- metabolic syndrome
- smoking cessation
- hiv infected
- contrast enhanced
- quality improvement
- patient reported
- blood brain barrier
- cerebral ischemia
- combination therapy
- acute care
- adverse drug
- subarachnoid hemorrhage
- weight loss