Evaluation of APRI Score-based hepatic fibrosis and cirrhosis among hepatitis C patients co-infected with schistosomiasis | ||
| Egyptian Pharmaceutical Journal | ||
| Volume 24, Issue 4, October 2025, Pages 132-146 PDF (491.15 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/epj.2025.452074 | ||
| Authors | ||
| Ahmed Khedr1; Mohamed Mokhles2 | ||
| 1Department of Microbial Biotechnology, Biotechnology Research Institute, National Research Centre, Cairo, Egypt | ||
| 2Department of Internal Medicine, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt | ||
| Abstract | ||
| Background Hepatitis C virus (HCV) causes severe liver pathology, and schistosomiasis (SCH), a neglected tropical disease, leads to hepatic damage. Objective This study aimed to report the incidence of SCH in HCV patients through serological detection of corresponding antibodies and to investigate the clinical outcomes of HCV/SCH co-infection, revealing its possible associations with aspartate aminotransferase-to-platelet ratio index (APRI) score-based hepatic fibrosis and the precence of cirrhosis. Materials and methods This study involved 132 participants (70 HCV patients and 62 controls). All participants underwent measurements of clinical parameters, including HCV RNA level. The APRI score was calculated to assess liver fibrosis and cirrhosis. Serologically, serum samples were examined for schistosomal antibodies. Results and conclusion HCV patients had a significantly higher incidence of SCH (38/70, 60%) compared to controls (6/62, 9.68%) (P < 0.001). HCV/SCH co-infected patients showed significantly higher levels of total bilirubin, direct bilirubin, prothrombin time (PT), international normalized ratio (INR), and APRI score compared to those with HCV mono-infection (P 0.002, 0.004, 0.006, 0.001, and 0.013, respectively). Likewise, albumin and prothrombin concentration (PC) levels decreased significantly in HCV/SCH co-infection (P 0.020 and 0.001, respectively). PC level, followed by APRI score, was the parameter most highly associated with HCV/SCH co-infection. Nevertheless, the diagnostic utility of APRI score to identify liver fibrosis and cirrhosis at cutoff values of 1.5 and 2, respectively, revealed no significant difference in hepatic fibrosis status between HCV/SCH co-infected patients compared to HCV mono-infected patients, nor in cirrhosis presence across the two groups. But, at the APRI score cutoff value of 1, HCV/SCH co-infected patients had a significantly lower likelihood of ruling out cirrhosis. In HCV/SCH co-infection, schistosomal antibody titres were significantly different regarding liver fibrosis status and cirrhosis (P 0.001 and < 0.001, respectively). It is concluded that the increased incidence of schistosomal antibodies in HCV patients is a well-defined pathologic issue that is not associated with liver fibrosis progression or cirrhosis, as assessed by the APRI score. However, HCV/SCH co-infection is associated with a reduced likelihood of ruling out liver cirrhosis. | ||
| Keywords | ||
| Hepatitis C virus; schistosomiasis; co-infection; APRI biomarker; liver fibrosis; cirrhosis | ||
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