Abstract
BackgroundClonorchis sinensis (C. sinensis) is considered to be an important parasitic zoonosis because it infects approximately 35 million people, while approximately 15 million were distributed in China. Hepatitis B virus (HBV) infection is a major public health issue. Two types of pathogens have the potential to cause human liver disease and eventually hepatocellular carcinoma. Concurrent infection with HBV and C. sinensis is often observed in some areas where C. sinensis is endemic. However, whether C. sinensis could impact HBV infection or vice versa remains unknown.Principal FindingsCo-infection with C. sinensis and HBV develops predominantly in males. Co-infected C. sinensis and HBV patients presented weaker liver function and higher HBV DNA titers. Combination treatment with antiviral and anti-C. sinensis drugs in co-infected patients could contribute to a reduction in viral load and help with liver function recovery. Excretory-secretory products (ESPs) may, in some ways, increase HBV viral replication in vitro. A mixture of ESP and HBV positive sera could induce peripheral blood mononuclear cells (PBMCs) to produce higher level of Th2 cytokines including IL-4, IL-6 and IL-10 compared to HBV alone, it seems that due to presence of ESP, the cytokine production shift towards Th2. C. sinensis/HBV co-infected patients showed higher serum IL-6 and IL-10 levels and lower serum IFN-γ levels.Conclusions/SignificancePatients with concomitant C. sinensis and HBV infection presented weaker liver function and higher HBV DNA copies. In co-infected patients, the efficacy of anti-viral treatment was better in patients who were prescribed with entecavir and praziquantel than entecavir alone. One possible reason for the weaker response to antiviral therapies in co-infected patients was the shift in cytokine production from Th1 to Th2 that may inhibit viral clearance. C. sinensis/HBV co-infection could exacerbate the imbalance of Th1/Th2 cytokine.
Highlights
Clonorchiasis, caused by Clonorchis sinensis (C. sinensis), is one of the parasitic zoonosis
Combination treatment with antiviral and anti-C. sinensis drugs in co-infected patients could contribute to a reduction in viral load and help with liver function recovery
Clonorchiasis and hepatitis B infection are infectious diseases that affect millions of people worldwide, especially in China. These two diseases are caused by two different pathogens, C. sinensis and hepatitis B virus, respectively
Summary
Clonorchiasis, caused by Clonorchis sinensis (C. sinensis), is one of the parasitic zoonosis. The adult worms of C. sinensis, located in the small bile ducts of the liver, lead to mechanical damage, while excretory-secretory products (ESPs) of C. sinensis cause chemical damage. Both mechanical damage and chemical damage play a key role in causing hyperplasia and adenomatous changes in the bile ducts[6]. Clonorchis sinensis (C. sinensis) is considered to be an important parasitic zoonosis because it infects approximately 35 million people, while approximately 15 million were distributed in China. Concurrent infection with HBV and C. sinensis is often observed in some areas where C. sinensis is endemic. Whether C. sinensis could impact HBV infection or vice versa remains unknown
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