Long-term Follow-up of Hepatobiliary Fascioliasis: Serologic and Computed Tomography Findings

Abstract

Background: Hepatobiliary fascioliasis (HF) is a significant public health concern. In humans, the diagnosis of fasciolosis typically relies on parasitological, immunological, and radiologic findings. Previous studies have documented long-term radiological findings post-treatment. However, there is insufficient data on the long-term follow-up of radiological results combined with anti-Fasciola antibody levels, which are crucial for diagnosing the disease. Objectives: This study aimed to evaluate the long-term laboratory findings, antibody levels, and radiological features following the treatment of patients with HF. Methods: This retrospective study included 25 patients with HF at Dicle University Medical Faculty Hospital from March 2009 to December 2015. Baseline and follow-up laboratory tests, anti-Fasciola antibody levels (mean follow-up: 43.0 ± 10.3 months post-treatment), and radiological results (mean follow-up: 37.9 ± 13.5 months post-treatment) were recorded. The follow-up results were compared with baseline data. Results: The study included 25 patients (20 female; mean age: 40.6 ± 11.7 years) diagnosed with HF. Significant changes were observed in eosinophil counts and Fasciola antibody levels. Antibody levels decreased in all patients, with antibody negativity developing in 40% (n = 10) of the patients. Biliary changes and intra-abdominal fluid resolved completely in all patients. Marked radiologic improvements were noted in lymphadenopathy, liver lesions, and splenomegaly. Both antibody negativity and radiological improvement were observed in 16% (n = 4) of the patients. No correlation was found between radiological improvement and antibody negativity or other parameters. Conclusions: In patients with HF, achieving antibody negativity and radiological improvement may require a prolonged period. During follow-up, radiological imaging and antibody levels should be interpreted cautiously in treated individuals whose laboratory tests, such as eosinophil count, are within the normal range.