Liver disease in Egypt: hepatitis C superseded schistosomiasis as a result of iatrogenic and biological factors
- PMID: 16628669
- DOI: 10.1002/hep.21173
Liver disease in Egypt: hepatitis C superseded schistosomiasis as a result of iatrogenic and biological factors
Abstract
In Egypt, schistosomiasis was traditionally the most important public health problem and infection with Schistosoma mansoni the major cause of liver disease. From the 1950s until the 1980s, the Egyptian Ministry of Health (MOH) undertook large control campaigns using intravenous tartar emetic, the standard treatment for schistosomiasis, as community-wide therapy. This commendable effort to control a major health problem unfortunately established a very large reservoir of hepatitis C virus (HCV) in the country. By the mid-1980s, the effective oral drug, praziquantel, replaced tartar emetic a s treatment f o r schistosomiasis in the entire country. This both reduced schistosomal transmission and disease and interrupted the "occult" HCV epidemic. It was evident when diagnostic serology became available in the 1990s that HCV had replaced schistosomiasis as the predominant cause of chronic liver disease. Epidemiological studies reported a high prevalence and incidence of HCV, particutarly within families in rural areas endemic for schistosomiasis. Clinical studies showed 70% to 90% of patients with chronic hepatitis, cirrhosis, or hepatocellular carcinoma had HCV infections. Co-infections with schistosomiasis caused more severe liver disease than infection with HCV alone. Schistosomiasis was reported to cause an imbalance in HCV-specific T-cell responses leading to increased viral load, a higher probability of HCV chronicity, and more rapid progression of complications in co-infected persons. As complications of HCV usually occur after 20 years of infection, the peak impact of the Egyptian outbreak has not yet occurred. Efforts have been initiated by the Egyptian MOH to prevent new infections and complications of HCV in the estimated 6 million infected persons.
Similar articles
-
Coinfection of Schistosoma Species with Hepatitis B or Hepatitis C Viruses.Adv Parasitol. 2016;91:111-231. doi: 10.1016/bs.apar.2015.12.003. Epub 2016 Feb 5. Adv Parasitol. 2016. PMID: 27015949 Review.
-
Clinical, virological and histopathological features: long-term follow-up in patients with chronic hepatitis C co-infected with S. mansoni.Liver. 2000 Jul;20(4):281-9. doi: 10.1034/j.1600-0676.2000.020004281.x. Liver. 2000. PMID: 10959806 Clinical Trial.
-
IL-4 and reactive oxygen species are elevated in Egyptian patients affected with schistosomal liver disease.Parasite Immunol. 2008 Nov-Dec;30(11-12):603-9. doi: 10.1111/j.1365-3024.2008.01061.x. Parasite Immunol. 2008. PMID: 19067841
-
In Egyptians, a mutation in the lymphotoxin-alpha gene may increase susceptibility to hepatitis C virus but not that to schistosomal infection.Ann Trop Med Parasitol. 2008 Dec;102(8):709-16. doi: 10.1179/136485908X337599. Ann Trop Med Parasitol. 2008. PMID: 19000388
-
Changing pattern of hepatocellular carcinoma (HCC) and its risk factors in Egypt: possibilities for prevention.Mutat Res. 2008 Jul-Aug;659(1-2):176-84. doi: 10.1016/j.mrrev.2008.01.005. Epub 2008 Jan 20. Mutat Res. 2008. PMID: 18346933 Review.
Cited by
-
HEPATOSPLENIC SCHISTOSOMIASIS-ASSOCIATED CHRONIC PORTAL VEIN THROMBOSIS: RISK FACTOR FOR HEPATOCELLULAR CARCINOMA?Arq Bras Cir Dig. 2023 Sep 15;36:e1763. doi: 10.1590/0102-672020230045e1763. eCollection 2023. Arq Bras Cir Dig. 2023. PMID: 37729278 Free PMC article.
-
Eliminating hepatitis C from countries with high prevalence: When infrastructure comes first.Indian J Med Res. 2021 Jul;154(1):1-3. doi: 10.4103/ijmr.ijmr_1911_21. Indian J Med Res. 2021. PMID: 34782521 Free PMC article. No abstract available.
-
The Manifesto of Pharmacoenosis: Merging HIV Pharmacology into Pathocoenosis and Syndemics in Developing Countries.Microorganisms. 2021 Jul 31;9(8):1648. doi: 10.3390/microorganisms9081648. Microorganisms. 2021. PMID: 34442727 Free PMC article. Review.
-
Does Schistosoma Mansoni Facilitate Carcinogenesis?Cells. 2021 Aug 4;10(8):1982. doi: 10.3390/cells10081982. Cells. 2021. PMID: 34440754 Free PMC article. Review.
-
A cross sectional study of the risk factors of hepatitis C infection in North Egypt.Virusdisease. 2021 Mar;32(1):22-28. doi: 10.1007/s13337-020-00639-2. Epub 2021 Mar 20. Virusdisease. 2021. PMID: 33969153 Free PMC article.
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Research Materials