Comparative analysis of anti-relapse treatment regimens in 110 patients with hepatic and pulmonary hydatid echinococcosis.

Abstract

Hydatid echinococcosis is worm disease caused by Echinococcus granulosus, that is primarily detected in the liver and lungs. This study aimed at determining the clinical tolerance and efficacy of albendazole in patients with cystic echinococcosis, depending on the volume of the previous one. We retrospectively (from 2016 to 2020 years) analyzed patients who have been treated with two treatment regimens (28-day courses with a 14-day break and continuous drug intake for 60 days), which are used in the Russian Federation. There were 110 patients (after surgery) who had hydatid echinococcosis of the liver and lungs; the diagnosis of these patients was confirmed morphologically (intra-vitam). A retrospective analysis was carried out on the following matters: (1) the duration of anti-relapse chemotherapy depending on the localization of the parasitic cyst; (2) chemotherapy's side effects and long-term relapses after treatment. We evaluated patients' tolerability of albendazole according to the level of blood cells count and hepatic enzymes. The effectiveness of anti-parasitic treatment was evaluated by imaging studies that did not reveal the growth of new parasitic cysts even in the presence of serum antibodies to echinococcal antigens. A correlation was found between the choice of antiparasitic treatment regimen and the frequency of adverse reactions in lab tests: more often adverse reactions (drug-induced hepatitis, anemia, granulocytopenia) occurred in patients who received a continuous treatment regimen for 60 days (p < 0.05). The frequency of relapses reached 4.5% and was more often observed in patients who received treatment for 28 days with a 14-day break. Continuous drug intake for 60 days is the most effective.