1. Hepatobiliary morbidities detected by ultrasonography in Opisthorchis viverrini-infected patients before and after praziquantel treatment: a five-year follow up study.
- Author
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Mairiang E, Laha T, Kaewkes S, Loukas A, Bethony J, Brindley PJ, and Sripa B
- Subjects
- Adult, Animals, Anthelmintics therapeutic use, Bile Ducts, Intrahepatic diagnostic imaging, Bile Ducts, Intrahepatic parasitology, Case-Control Studies, Cholangiocarcinoma diagnostic imaging, Cholangiocarcinoma parasitology, Female, Fibrosis diagnostic imaging, Fibrosis parasitology, Follow-Up Studies, Gallbladder diagnostic imaging, Gallstones diagnostic imaging, Gallstones parasitology, Humans, Male, Middle Aged, Morbidity, Opisthorchiasis drug therapy, Opisthorchis, Recurrence, Thailand epidemiology, Ultrasonography, Young Adult, Digestive System Diseases diagnostic imaging, Digestive System Diseases epidemiology, Digestive System Diseases parasitology, Opisthorchiasis complications, Praziquantel therapeutic use
- Abstract
Infection of the liver fluke, Opisthorchis viverrini (OV) is an important public health problem in northeast Thailand and adjacent countries, where people have a habit of eating raw or undercooked fish. A community case-control study was carried out with 8,936 participants from 89 villages, in Khon Kaen province, Thailand. There were 3,359 OV-infected participants all of whom underwent ultrasonography of upper abdomen for the evaluation of hepatobiliary morbidity. The participants with advanced periductal fibrosis (APF) by ultrasound (n = 785) were invited to undergo annual follow-up ultrasonography for five years after praziquantel treatment. The sonographer was blinded with respect to status of OV infection at each visit. The study findings revealed variability in the study population profile of the hepatobiliary morbidities before and after praziquantel treatment over the follow up interval. At the end of the study, 32 (30.8%) out of 104 participants showed no relapse of APF whereas, by contrast, 39 (37.5%) participants showed relapse or persistent APF since the outset of the study (≥ two consecutive visits). The APF in most follow-up visits was significantly associated with male sex, with intrahepatic duct stones, with the width of the gallbladder "pre" minus "post" fatty meal, and with the ratio of left lobe of the liver to aorta. Five cases of suspected cholangiocarcinoma were observed over the five years of follow-up. This long-term ultrasound follow-up study demonstrates a significant incidence of persistent APF in over one-third of opisthorchiasis cases after praziquantel treatment, findings that support the prospect of ongoing cholangiocarcinogenesis long after successful elimination of liver fluke infection among the population., (Copyright © 2021. Published by Elsevier B.V.)
- Published
- 2021
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