Patient Selection
According to the national standardized diagnostic criteria for
schistosomiasi28, the inclusion criteria for advanced
schistosomiasis cases were: (1) history of repeated or prolonged
exposure to infested water, or history of schistosomiasis treatment; (2)
eggs found in the fecal examination, or positive serum immunology
(enzyme-linked immunosorbent assay, ELISA); (3) portal hypertension
syndrome resulting from hepatic fibrosis, splenomegaly ≥ Hackett grade
3, or splenomegaly of Hackett grade 2 with hypersplenism or upper
gastrointestinal bleeding or varices of esophagus and fundus of the
stomach; and (4) portal hypertension syndrome resulting from hepatic
fibrosis or splenomegaly or ascites, which were caused by
schistosomiasis. The inclusion criteria for chronic schistosomiasis
cases were: (1) history of repeated or prolonged exposure to infested
water, or history of schistosomiasis treatment; (2) eggs found in the
fecal examination, or positive serum immunology (enzyme-linked
immunosorbent assay, ELISA); (3) no obvious clinical symptoms, or
intermittent abdominal pain, diarrhea or purulent blood stools, most
were associated with hepatomegaly, mainly in the left lobe, and a few
with splenomegaly. Exclusion criteria were pregnancy or diseases
affecting the immune response (HIV, HTLV-1, and diabetes), individuals
with other liver diseases associated with portal hypertension (e.g.,
hepatitis A, B, and C), and acute viral or bacterial infections at the
time of blood collection, and patients who had not completed an
immunologic evaluation.