Impact of hepatitis C virus infection on schistosomal liver disease.

BACKGROUND/AIMS: This study was conducted to determine whether Hepatitis C virus infection has a role in patients with schistosomal liver disease. METHODOLOGY: Sixty patients with hepatosplenic schistosomiasis and evidence of portal hypertension were seen at the Armed Forces Hospital Riyadh, Saudi Arabia over 5 years. The impact of Hepatitis C virus infection on chronic schistosomal liver disease was studied in 30 of these patients (group one) who were Hepatitis C virus positive and compared with the other 30 patients (group two) who were Hepatitis C virus negative (control group). RESULTS: Hepatitis C virus may be an important factor contributing to deterioration of liver function for patients with hepatosplenic schistosomiasis. Liver functions showed elevated ALT in 83.3% in group one compared to 23.4% in group two. Liver biopsy in 19 patients (group one) and 16 patients (group two) showed evidence of schistosomiasis and in patients of group one, liver biopsy also showed chronic active hepatitis together with Schistosoma in 57.9%, and cirrhosis in 31.6%. None of group two patients had cirrhosis. Alpha-fetoprotein levels were elevated in 16 patients (group one) and 3 of these patients had hepatocellular carcinoma. None of the control group had radiological or histological evidence of hepatocellular carcinoma. CONCLUSION: The mean age of HCV positive patients was less than the HCV negative patients, which may indicate that Hepatitis C virus infection leads to decompensation of liver function earlier in patients with Schistosoma and severe liver disease may be promoted at a younger age in Schistosoma patients with hepatitis C.