Albendazolesulphoxide concentrations in plasma and hydatid cyst and prediction of parasitological and clinical outcomes in patients with liver hydatidosis caused by Echinococcus granulosus

Scientific paper - Original scientific paper

• Author: Tomislava Skuhala
• Author: Vladimir Trkulja
• Author: Mislav Runje
• Author: Dalibor Vukelić
• Author: Boško Desnica
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

AIM:

To investigate the relationship between plasma and cyst concentrations of albendazolesulphoxide (ASO) and their effects on parasitological findings and disease recurrence in patients with liver hydatidosis. ----- METHODS:

The study was conducted at the University Hospital for Infectious Diseases Dr. Fran Mihaljević, Zagreb, Croatia, between August 2006 and January 2011. Consecutive patients (N=48, age 6-77 years) were treated with albendazole (3×5 mg/kg/d) over 28 days before surgical cyst removal (n=34) or percutaneous evacuation (PAIR) (n=14). Plasma ASO was determined on days 10 and 28 of treatment and cyst concentrations at surgery/PAIR. ----- RESULTS:

Disease recurred in 3 surgically treated patients. Variability of ASO concentrations was substantial. Plasma concentrations on day 10 were higher than on day 28 (geometric means ratio [GMR] 2.00; 95%CI 1.38-2.91, P<0.001) and higher than cyst concentrations at the time of treatment (GMR=1.58, 1.01-2.34, P=0.045). Higher cyst (but not plasma) concentrations were independently associated with lower odds of protoscolex motility (OR=0.23, 0.01-0.70, P<0.001) and higher odds of protoscolex destruction (OR=1.17, 1.04-1.46, P<0.001). With adjustment for age and protoscolex motility, higher day 10 plasma concentrations (but not cyst concentrations) were associated with lower odds of disease recurrence (OR=0.49, 0.09-0.97, P=0.035). Plasma concentrations did not predict cyst concentrations. ----- CONCLUSION:

Viability of protoscolices progressively decreased with increasing ASO concentrations in the cyst. Data strongly suggested that higher plasma concentrations reduced the risk of disease recurrence.

• Keywords (english): Adolescent; Adult; Aged; Albendazole/analogs & derivatives; Albendazole/pharmacokinetics; Animals; Anthelmintics/pharmacokinetics; Antibodies, Helminth/blood; Antigens, Helminth/immunology; Biological Availability; Child; Echinococcosis, Hepatic/diagnosis; Echinococcosis, Hepatic/drug therapy; Echinococcosis, Hepatic/metabolism; Echinococcosis, Hepatic/surgery; Echinococcus granulosus/drug effects; Echinococcus granulosus/immunology; Enzyme-Linked Immunosorbent Assay; Female; Humans; Male; Middle Aged; Recurrence; Treatment Outcome; Young Adult
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Croatian Medical Journal
• Numbering: vol. 55, no. 2, pp. 146-155
• p-ISSN: 0353-9504
• DOI: https://doi.org/10.3325/cmj.2014.55.146
• URN:NBN: urn:nbn:hr:105:418447
• Publication: 2014-04
• Document URL: https://doi.org/10.3325/cmj.2014.55.146
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-27 20:08:52