The impact of schistosomiasis co-infection in the presentation of viral hepatitis B in migrants: An observational study in non-endemic area

Travel Med Infect Dis. 2020 May-Jun:35:101467. doi: 10.1016/j.tmaid.2019.101467. Epub 2019 Aug 23.

Abstract

Background: In Europe, the prevalence rates of schistosomiasis and HBV infection in migrants from sub-Saharan Africa are high. The co-infection schistosomiasis-HBV has been scarcely studied.

Methods: This is a retrospective study assessing differences in clinical presentation, laboratory and ultrasound findings in a cohort of migrants admitted at the Department of Infectious - Tropical Diseases and Microbiology IRCCS Sacro Cuore Don Calabria Hospital of Negrar (Northeast Italy) with schistosomiasis, HBV infection or both.

Results: Of the 227 migrants, 175 (77.1%) with a diagnosis of schistosomiasis were classified as SCHISTO group, 35 (15.4%) with schistosomiasis and hepatitis B were classified as SCHISTO/HBV group, and 17 (7.5%) patients with a diagnosis of HBV infection were classified as HBV group. S. mansoni was found in 47 patients, classified in MANSONI (38/175, 21.7%) or MANSONI/HBV (9/35, 25.7%) group depending on HBsAg status. Mean transaminases and APRI index values were higher in SCHISTO/HBV compared to SCHISTO group (p < 0.01). AST differed between MANSONI/HBV and MANSONI group (p = 0.038). No differences were found between SCHISTO/HBV and HBV group. Eosinophil count and total IgE differed only between MANSONI/HBV and HBV group (p = 0,049).

Conclusions: Schistosomiasis seems not to increase the liver damage in people with HBV infection. Conversely, finding elevated transaminases in patients with schistosomiasis should alert for presence of HBV.

Keywords: HBV; Hepatitis; Liver fibrosis; Migrant; Schistosomiasis.

MeSH terms

  • Abdomen / diagnostic imaging
  • Adolescent
  • Adult
  • Animals
  • Coinfection / epidemiology*
  • Coinfection / parasitology
  • Coinfection / virology
  • Female
  • Hepatitis B / epidemiology*
  • Humans
  • Italy / epidemiology
  • Liver Cirrhosis
  • Male
  • Retrospective Studies
  • Schistosoma haematobium / isolation & purification
  • Schistosoma mansoni / isolation & purification
  • Schistosomiasis / epidemiology*
  • Transaminases / blood
  • Transients and Migrants / statistics & numerical data*
  • Ultrasonography

Substances

  • Transaminases