Natural History of Hepatosplenic Schistosomiasis (HSS) Non-Cirrhotic Portal Hypertension (NCPH): Influence of Gastrointestinal Bleeding and Decompensation in Prognosis

Hepatosplenic schistosomiasis (HSS) is a peculiar form of non-cirrhotic portal hypertension (NCPH). Although HSS patients present normal hepatic function, some evolve signs of hepatocellular failure and features of decompensated cirrhosis. The natural history of HSS-NCPH is unknown. A retrospective...

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Published in:Tropical medicine and infectious disease 2023-02, Vol.8 (3), p.145
Main Authors: Veiga, Zulane S T, Fernandes, Flávia F, Guimarães, Lívia, Piedade, Juliana, Pereira, Gustavo Henrique S
Format: Article
Language:English
Subjects:
Abdomen
Anemia
Ascites
Bacterial infections
Disease prevention
Endoscopy
Epidemiology
Esophagus
Hemoglobin
hepatosplenic schistosomiasis
Hypertension
Infections
Liver cirrhosis
liver disease decompensation
Liver diseases
Medical prognosis
Mortality
Natural history
non-cirrhotic portal hypertension
Peritonitis
Software
Statistical analysis
survival
Thrombocytopenia
Transplants & implants
Tropical diseases
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Summary:Hepatosplenic schistosomiasis (HSS) is a peculiar form of non-cirrhotic portal hypertension (NCPH). Although HSS patients present normal hepatic function, some evolve signs of hepatocellular failure and features of decompensated cirrhosis. The natural history of HSS-NCPH is unknown. A retrospective study was conducted that evaluated patients who fulfilled clinical-laboratorial criteria for HSS. A total of 105 patients were included. Eleven patients already presented with decompensated disease and had lower transplant-free survival at 5 years than those without (61% vs. 95%, = 0.015). Among 94 patients without prior decompensation, the median follow-up was 62 months and 44% of them had varicose bleeding (two or more episodes in 27%). Twenty-one patients presented at least one episode of decompensation (10-year probability 38%). Upon multivariate analysis, varicose bleeding and higher bilirubin levels were associated with decompensation. The 10-year probability of survival was 87%. Development of decompensation and age were predictive of mortality. HSS is characterized by multiple episodes of GI bleeding, a high probability of decompensation and reduced survival at the end of the first decade. Decompensation is more common in patients with varicose esophageal bleeding and is associated with lower survival.
ISSN:2414-6366
2414-6366
DOI:10.3390/tropicalmed8030145