Schistosoma mansoni-Hepatitis B co-infection among adult patients with periportal fibrosis: a cross sectional study
Schistosoma mansoni-Hepatitis B co-infection among adult patients with periportal fibrosis: a cross sectional study
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门静脉周围纤维化成年患者中曼氏血吸虫与乙型肝炎的双重感染：一项横断面研究
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
H. Mazigo
中科院分区：
文献类型：
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作者：
D. Gunda;Elizabeth F. Mtui;S. Kilonzo;B. Kidenya;H. Mazigo
目的：慢性曼氏血吸虫感染是撒哈拉以南非洲门静脉周围纤维化的常见原因。大约有2000万人患有慢性S。曼森感染，每年死亡20万人。B型肝炎合并感染可高度改变门静脉周围纤维化的结局，这可能导致快速进展为纤维化和失代偿。在坦桑尼亚，S.曼氏和B型肝炎是高度流行的;然而，在医院环境中门静脉周围纤维化患者的合并感染尚未被描述。方法：采用横断面研究方法，对2004年12月至2005年12月在我院住院的S。曼氏症相关的门静脉周围纤维化。计算了193例患者的最小样本，并使用STATA 13分析了患者的临床、实验室、超声和内窥镜数据。S.计算曼氏-B型肝炎合并感染的发生率，并采用Logistic回归模型确定其相关性。结果：共分析250例患者，发现40例（16.0%）有S。曼氏-B型肝炎合并感染者更有可能具有较高的AST水平（58 vs. 38 U/L; OR：1.03; p=0.033）、较高的APRI水平（1.8 vs. 1.05; OR：2.1; P=0.03）;腹水（OR：2.9; p=0.049）和较高的死亡率（OR：2.9; p=0.032）。结论：S. mansoni -门静脉周围纤维化患者中常见B型肝炎合并感染。这项研究中发现的相关性表明，合并感染的患者更有可能发生严重的肝损伤，严重纤维化、失代偿和死亡的风险增加。本研究强烈建议定期筛查B型肝炎并对高危人群进行疫苗接种。微生物感染与疾病杂志2020; 10（3）：136-143。
Objectives: Chronic Schistosoma mansoni infection is a common cause of periportal fibrosis in Sub Saharan Africa. About 20 million people are suffering complications of chronic S. mansoni infection with an annual mortality of 0.2million people. The outcome of periportal fibrosis is highly modified by hepatitis B co-infection which may cause a rapid progression to fibrosis and decompensation. In Tanzania both S. mansoni and hepatitis B are highly endemic; however, the co-infection among patients with periportal fibrosis in the hospital setting has not been described. Methods : A cross-sectional study was done among patients with S. mansoni related periportal fibrosis at Bugando hospital. A minimum sample of 193 patients was calculated and, patients’ clinical, laboratory, ultrasound and endoscopic data were analyzed using STATA 13. The prevalence of S. mansoni -hepatitis B co-infection was calculated and its correlates were determined by logistic regression model. Results : In total 250 patients were analyzed in this study and, 40 (16.0%) were found to have S. mansoni -Hepatitis B co-infection who were more likely to have higher AST levels, (58 vs. 38U/L; OR: 1.03; p=0.033), higher APRI levels, (1.8 vs. 1.05; OR: 2.1; P=0.03); ascites, (OR: 2.9; p=0.049) with higher mortality, (OR: 2.9; p=0.032). Conclusions : The S. mansoni -Hepatitis B co-infection is common among patients with periportal fibrosis. The correlates found in this study, suggest that co-infected patients are more likely to have a severe liver injury with increased risk of severe fibrosis, decompensation, and mortality. Regular screening for hepatitis B and vaccination of people at-risk is highly suggested in this study. J Microbiol Infect Dis 2020; 10(3):136-143.