a b s t r a c t
Background and study aims: Both hepatitis C virus (HCV) and schistosomiasis are highly endemic in Egypt
and coinfection is frequently encountered. Such coinfection is responsible for leading to a more severe
liver disease. Hence, the aim of the study was to assess the fibroscan in chronic HCV patients coinfected
with Schistosoma.
Patients and methods: This study included 231 chronic HCV patients. Routine pre-treatment work-up was
done including anti-schistosomal antibodies. Liver stiffness measurements using fibroscan and reference
needle-liver biopsy were done. Patients were categorised into two groups: HCV patients with positive
schistosomal serology and HCV patients with negative schistosomal serology.
Results: Anti-schistosomal antibody was positive in 29% of the studied population. Positive schistosomal
serology status was significantly associated with the disagreement between the results of liver biopsy
(Metavir) and the fibroscan results (p value = 0.02), which was more obvious in F2 and F3 fibrosis stages.
The sensitivity of fibroscan for the detection of the F2 stage decreased from 64% among negative schistosomal
serology patients to 30.8% among positive schistosomal serology patients, and for the F3 stage
it decreased from 43.8% to 21.4%, respectively. Multivariate logistic regression showed that fibrosis stages
(F0–F1 and F4) were the most independent factors that were associated with the agreement between
fibroscan and liver biopsy (odds ratio (OR) 3.4, 7.12 and p value <0.001, <0.001, respectively). Conclusion: Although the sensitivity of fibroscan for the detection of fibrosis stages (F2 and F3) was impaired in patients with positive schistosomal serology, fibrosis stages (F0–F1 and F4) were the most independent factors associated with the agreement between fibroscan and liver biopsy