Clinical tolerance and efficacy of anti-parasitic treatment with albendazole in patients with alveolar echinococcosis: long-term follow-up observation in 117 patients.

Abstract

Alveolar echinococcosis is the most severe worm disease primarily detected in the liver. This study aimed to determine the clinical tolerance and efficacy of albendazole in patients with alveolar echinococcosis, depending on the volume of previous surgical treatment or its absence and the duration of anti-parasitic therapy. We retrospectively (over the last 15 years) analyzed the data of 117 patients, who were divided into 4 groups according to curability: R0 (radical resection), R1+2 (incomplete resection), Nr (unresectable), and Rr (recurrence). All of them received albendazole from 3 months to 11 years, depending on the volume of resection. We evaluated patients' tolerability of albendazole according to the level of hepatic transaminases and blood cell count. The effectiveness of anti-parasitic treatment was evaluated by imaging studies and the absence of serum antibodies. There was no direct relationship between the frequency of adverse reactions and the duration of taking albendazole (r - 0.20229). Adverse reactions were significantly more often observed in unresectable patients (p < 0.01), which is most likely associated with the general serious condition of the patients and with individual drug intolerance. The effectiveness of the anti-parasitic treatment was manifested in the inhibition of tumor development in 88% of patients in group R1+2 and 60% in group Nr. Follow-up of group R0 patients from 3 to 14 years did not reveal new lesions of the liver and other organs. The chance of a complete cure depends on the early detection of a parasitic tumor and can reach 50%.