Study of the peculiarities of combined opisthorchosis and helicobacteriosis

The purpose of the research is identifying patients with helicobacteriosis and opisthorchosis, and determining regular features of the course of combined diseases.

Materials and methods. The study involved 50 patients in the Gastroenterology Department with helicobacteriosis diagnosed. Helicobacter pylori was confirmed by the HP test during fibrogastroduodenoscopy. Opisthorchis felineus was detected in patients using the study of feces by the Kato technique and enrichment method. The patients were divided into 2 groups of 25 people each. The first group only consisted of patients with H. pylori. The second group consisted of patients in whom H. pуlori and O. felineus were identified. Initially, the levels of aminotransferases and bilirubin were assessed using a biochemical blood test on a MIURA 200 apparatus. The manifestation of such clinical symptoms as abdominal pain was assessed using a visual analogue scale (VAS). Further, the eradication of H. pylori during therapy was assessed based on the Maastricht V recommendations for 14 days, including the use of three drugs: omeprazole at a dose of 20 mg 2 times a day, clarithromycin – 500 mg 2 times a day, amoxicillin – 1000 mg 2 times a day, and the effectivity of treatment of patients of the second group with opisthorchosis with the use of praziquantel at a dose of 60 mg/kg of body weight during the day three times every 4 hours.

Results and discussion. In the second group of patients with combined pathology, pain intensity was estimated at 4–5 scores in 20 people (80%), and at 2–3 scores in 25 people (100%) in the first group. The severity of nausea was also higher in 100% of patients in the second group. Values for AST and ALT in blood were higher in patients of the second group – by an average of 50–100% in 18 people (72%); increase in the level of bilirubin by 15% in 23 people (92%). Combined pathology (opisthorchosis and helicobacteriosis) is accompanied by more pronounced clinical symptoms (abdominal pain and nausea). In patients with opisthorchosis and H. pуlori, aminotransferases increased up to three reference values and bilirubin increased by 15% were noted. For helicobacteriosis and opisthorchosis, longer treatment was required. The presence of H. pylori at the same time with opisthorchosis did not affect the efficacy of antiparasitic therapy.

1. Beloborodova E. I., Kalyuzhina M. I., Tilichenko Yu. A., Tun M. A., Kolosovskaya T. A., Kritskaya N. G. Chronic opisthorchosis and the digestive system: monograph. Tomsk, 1996; 116. (In Russ.)

2. Beer S. A. Parasitological monitoring in Russia (the bases of the concept). Meditsinskaya parazitologiya i parazitarnyye bolezni = Medical parasitology and parasitic diseases. 1997; 1: 3-8. (In Russ.)

3. Bibik O. I., Kirsanova D. V., Barsukova V. I. Helminthosis occurs much more often than people may think. "Organism and the environment of life": proceedings of the 2nd Interregional Scientific and Practical Conference dedicated to the C. F. Roullier’s 205th birthday anniversary. Kemerovo, 2019; 9-17. (In Russ.)

4. Bibik O. I., Nacheva L. V. Parasitic diseases widespread in the Kuzbass (prevalence, control and prevention measures). Methodical recommendations (for doctors of practical health care and veterinary medicine, students, residents and graduate students of the relevant profile). Kemerovo, 2010; 63. (In Russ.)

5. Brusentsov I. I. Genetic diversity and phylogeography of Opisthorchis felineus. "Parasitology in a changing world": collected works of the All-Russian Conference with international participation. Novosibirsk, 2013; 33. (In Russ.)

6. Healthcare in Russia. 2019: Statistical Abstract/ Rosstat. М., 2019; 33. https://www.gks.ru/storage/mediabank/Zdravoohran-2019.pdf

7. Instructions for use Biltricid. https://www.vidal.ru/drugs/biltricid__118.

8. Nacheva L. V., Bibik O. I., Starchenkova T. E., Dodonov M. V. Helminthosis among the population of the Kuzbass. Meditsina v Kuzbasse = Medicine in the Kuzbass. Kemerovo, 2007; 1: 22-29. (In Russ.)

9. Nacheva L. V., Starchenkova T. E., Bibik O. I., Dodonov M. V. Opisthorchosis in the Kemerovo Region. Meditsinskaya parazitologiya i parazitarnyye bolezni = Medical parasitology and parasitic diseases. 2007; 1: 25-28. (In Russ.)

10. On sanitary and epidemiological welfare of the population in the Kemerovo Region, the Kuzbass in 2019: State report. – Office of the Federal Service for Supervision on Consumer Rights Protection and Human Wellbeing in the Kemerovo Region, the Kuzbass, 2020; 242-243. http://42.rospotrebnadzor.ru/content/813/94896/

11. On sanitary and epidemiological welfare of the population in the Russian Federation in 2019: State report. М.: Federal Service for Supervision on Consumer Rights Protection and Human Wellbeing, 2020; 196-197. https://www.rospotrebnadzor.ru/upload/iblock/8e4/gosdoklad-za-2019_seb_29_05.pdf

12. Solodovnik A. G., Lastochkina L. A., Pomytkina T. E., Poltavtseva O. V., Mozes K. B. Diagnostics, treatment and rehabilitation of internal medicine diseases in outpatient practice: guidelines for doctors. Kemerovo, 2017; 128. (In Russ.)

13. Fedorova O. S., Kovshirina Yu. V., Kovshirina A. E., Fedotova M. M., Deev I. A., Petrovsky F. I., Filimonov A. V., Dmitrieva A. I., Kudyakov L. A., Saltykova I. V., Mikhalev E. V., Odermatt P., Ogorodova L. M. Analysis of Opisthorchis felineus infection and liver and intrahepatic bile ducts cancer incidence rate in the Russian Federation. Byulleten' sibirskoy meditsiny = Bulletin of Siberian Medicine. 2016; 15 (5): 147- 158. DOI 10.20538/1682-0363-2016-5-147–158

14. Dangtakot R., Pinlaor S., Itthitaetrakool U., Chaidee A., Chomvarin C., Sangka A., Wilailuckana C., Pinlaor P. Coinfection with Helicobacter pylori and Opisthorchis viverrini enhances the severity of hepatobiliary abnormalities in hamsters. Infection and Immunity. 2017; 85 (4): 9-17. https://doi.org/10.1128/IAI.00009-17.

15. Deenonpoe R., Chomvarin C., Pairojkul C., Chamgramol Y., Loukas A., Brindley P.J., Sripa B. The Carcinogenic Liver Fluke Opisthorchis viverrini is a Reservoir for Species of Helicobacter. Asian Pacific Journal of Cancer Prevention. 2015; 16 (5): 1751–1758. DOI: 10.7314/APJCP.2015.16.5.1751

16. Malfertheiner P., Megraud F., O'Morain C. A., Gisbert J. P., Kuipers E. J., Axon A. T., Bazzoli F., Gasbarrini A., Atherton J., Graham D. Y., Hunt R., Moayyedi P., Rokkas T., Rugge M., Selgrad M., Suerbaum S., Sugano K., El-Omar E. M. Management of Helicobacter pylori infection – the Maastricht V/Florence Consensus Report. Gut. 2017; 66 (1): 6-30.

17. Plavnik R., Nevmerzhitskiy V., Embutniex Yu., Voynovan I., Kondrasheva E., Abdulova M., Bordin D. The prevalence of Helicobacter pylori in Russia. Helicobacter. 2018; 23 (1): 37-38.