10.1371/journal.pntd.0004806 Wenfang Li Wenfang Li Huimin Dong Huimin Dong Yan Huang Yan Huang Tingjin Chen Tingjin Chen Xiangzhan Kong Xiangzhan Kong Hengchang Sun Hengchang Sun Xinbing Yu Xinbing Yu Jin Xu Jin Xu <i>Clonorchis sinensis</i> Co-infection Could Affect the Disease State and Treatment Response of HBV Patients Public Library of Science 2016 HBV DNA titers Th 2. C Clonorchis sinensis Co-infection hepatitis B virus liver function recovery co-infected patients HBV infection serum IFN -γ levels liver function PBMC HBV Patients Background Clonorchis sinensis IL -10 levels HBV DNA copies Th 2 cytokines ESP Principal Findings Co-infection cytokine production shift serum IL -6 2016-06-27 19:05:35 Dataset https://plos.figshare.com/articles/dataset/_i_Clonorchis_sinensis_i_Co-infection_Could_Affect_the_Disease_State_and_Treatment_Response_of_HBV_Patients/3923016 <div><p>Background</p><p><i>Clonorchis sinensis</i> (<i>C</i>. <i>sinensis</i>) is considered to be an important parasitic zoonosis because it infects approximately 35 million people, while approximately 15 million were distributed in China. Hepatitis B virus (HBV) infection is a major public health issue. Two types of pathogens have the potential to cause human liver disease and eventually hepatocellular carcinoma. Concurrent infection with HBV and <i>C</i>. <i>sinensis</i> is often observed in some areas where <i>C</i>. <i>sinensis</i> is endemic. However, whether <i>C</i>. <i>sinensis</i> could impact HBV infection or vice versa remains unknown.</p><p>Principal Findings</p><p>Co-infection with <i>C</i>. <i>sinensis</i> and HBV develops predominantly in males. Co-infected <i>C</i>. <i>sinensis</i> and HBV patients presented weaker liver function and higher HBV DNA titers. Combination treatment with antiviral and anti-<i>C</i>. <i>sinensis</i> drugs in co-infected patients could contribute to a reduction in viral load and help with liver function recovery. Excretory-secretory products (ESPs) may, in some ways, increase HBV viral replication <i>in vitro</i>. A mixture of ESP and HBV positive sera could induce peripheral blood mononuclear cells (PBMCs) to produce higher level of Th2 cytokines including IL-4, IL-6 and IL-10 compared to HBV alone, it seems that due to presence of ESP, the cytokine production shift towards Th2. <i>C</i>. <i>sinensis</i>/HBV co-infected patients showed higher serum IL-6 and IL-10 levels and lower serum IFN-γ levels.</p><p>Conclusions/Significance</p><p>Patients with concomitant <i>C</i>. <i>sinensis</i> and HBV infection presented weaker liver function and higher HBV DNA copies. In co-infected patients, the efficacy of anti-viral treatment was better in patients who were prescribed with entecavir and praziquantel than entecavir alone. One possible reason for the weaker response to antiviral therapies in co-infected patients was the shift in cytokine production from Th1 to Th2 that may inhibit viral clearance. <i>C</i>. <i>sinensis</i>/HBV co-infection could exacerbate the imbalance of Th1/Th2 cytokine.</p></div>