Long-Term Evaluation of Patients with Hydatidosis Treated with Albendazole and Praziquantel

Abstract

Hydatidosis is a usually asymptomatic chronic disease. In most patients who undergo surgery, hydatidosis is not resolved due to high recurrence rate. However, long-term treatment with albendazole has been found to have a significant efficacy that has been further improved when albendazole is combined with praziquantel and fat-rich diet. In this study a retrospective evaluation of the outcome of hydatidosis in 70 patients, was performed. In group A, a combined chemotherapy of albendazole plus praziquantel was given after surgical removal of cysts. In group B chemotherapy alone was administered without surgery. Sera of all patients were assayed for IgG, IgM, IgA and IgE antibodies by ELISA. In addition, ultrasonography (US) and/or computerized tomography (CT) scans were performed every 3 months for 18 months, and then, each year until the end of follow-up. The difference between the two kinds of treatment used in the present study was found to be not significant, nor was the difference of the shrinkage and extended calcification of the HCs between the two groups. However, the difference of the shrinkage of the HCs of more than 80%, as well as the extended calcifications of the cysts between the two groups were found to be statistically significant. In all patients high levels of IgG and IgA were detected, while IgE in group A and/or IgM in group B were marginally detected above the background level throughout the study. Level of IgG was strongly fluctuated and significantly decreased at 11.7 years after the end of chemotherapy, or at 8.5 years after relapses in group A, while was dramatically decreased at 3.6 years after the termination of chemotherapy in group B. Relapses occurred in 11.4% of patients within the first six months after end of chemotherapy. After additional chemotherapy with albendazole for 3-6 months, all of them were considered cured at 8.5 years of follow up.