Co-Infection With Schistosomiasis Does Not Worsen Liver Damage in HBV

Liver schistosomiasis, light micrograph, photo under microscope showing presence of Schistosoma ova, calcified eggs of the flat worm, in hepatic tissue
Researchers found data that showed schistosomiasis does not escalate liver damage in patients who are infected with the hepatitis B virus.

Co-infection with schistosomiasis does not appear to worsen liver damage in patients with hepatitis B virus (HBV) infection. However, screening for schistosomiasis is still warranted in endemic areas, according to a retrospective study published in Travel Medicine and Infectious Disease.

Schistosomiasis is caused by trematode parasites of the genus Schistosoma and is highly prevalent in migrants from sub-Saharan Africa with HBV infection. However, this co-infection has rarely been studied. Therefore, researchers assessed differences in clinical presentation and laboratory and ultrasound findings in a cohort of 227 migrants admitted to the Department of Infectious – Tropical Diseases and Microbiology IRCCS Sacro Cuore Don Calabria Hospital of Negrar in Northeast Italy. Of these patients, 175 (77.1%) had a diagnosis of schistosomiasis, 35 (15.4%) had a diagnosis of schistosomiasis and HBV, and 17 (7.5%) had a diagnosis of HBV infection alone.

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S mansoni was found in 47 patients, 38 in the schistosomiasis group and 9 in the schistosomiasis and HBV group. Mean transaminases and aspartate aminotransferase (AST)-Platelet Ratio Index values were higher in those in the schistosomiasis and HBV group compared with those who had schistosomiasis alone (P <0.01), but there were no differences in AST. Differences in AST were observed only in patients with S mansoni, with or without HBV co-infection (P =.038), whereas eosinophil count and total immunoglobulin E differed in those with HBV with or without S mansoni co-infection (P =.049).

The authors suggested, “Schistosomiasis seems not to increase the liver damage in people with HBV infection.” However, “finding elevated transaminases in patients with schistosomiasis should alert for presence of HBV,” they concluded.


Marchese V, Beltrame A, Angheben A, Marocco S, Gaeta GB, Bisoffi Z. The impact of schistosomiasis co-infection in the presentation of viral hepatitis B in migrants: an observational study in non-endemic area [published online August 23, 2019]. Travel Med Infect Dis. doi:10.1016/j.tmaid.2019.101467