Assessment of Praziquantel Effect and Some Genetic Factors on Prognosis of Periportal Fibrosis in Intestinal Schistosomiasis Patients in Gezira State

Abstract

Schistosoma mansoni infection in Sudan causes serious health problems and economic consequences especially among schoolchildren, women of reproductive age and the working group of agriculture-associated people Praziquantel has been introduced as the drug of choice for control of infection . The aim of this study was to cast a light on the possible affect of praziquantel and some genetic factor on regression of the grade of Periportal fibrosis PPF 12 months after treatment of infected patients with S.mansoni . The study enrolled 100 Sudanese nationals diagnosed as schistosomiasis patients in um-zukra with active S.mansoni infection complicated with different grades of PPF were enrolled in the study. All the participants underwent abdominal ultrasonography evaluating the grade of PPF and given praziquantel as treatment according to appropriate dose for each of them (40 mg/kg BW). They were further assessed by ultrasonography 12 months later. The study found that, 46 (46%) grades of PPF regressed to the lower grades of fibrosis, 34 (34%) remained stable and 20(20%) progressed to the higher grades of fibrosis. Age and gender were significantly associated with changes in grades of PPF. Regression of PPF among females was more frequent than in males patients. Three polymorphisms (IFN- rs2069705 (C/T), TGF-1+869 T/C and ILB-1-31T/C that had screened to assess their role in regression or progression of PPF after praziquantel therapy showed that there was no significant association between this polymorphism and disease prognosis (P.value :0.35) However TGF- 1 +869 T/C- T/T homozygous and C/T heterozygous genotypes were more frequent in subjects with low grade of fibrosis (72.7%, P.value :0.029) (F I) Similarly (ILB-1 31 T/C) TT homozygous and CT heterozygous genotypes were significantly more frequent in subjects with low grade of fibrosis(P.value :0.0001). in conculation While polymorphism may not contribute to PPF prognosis ,yet it could be a predisposing factor