Effective Targeted Chemoprophylaxis of Recurrent Liver Echinococcosis with Haplotype CYP1A2F1*A/A: a Clinical Case

Abstract

Background. One of the main long­term quality criteria for treatment and prevention of echinococcosis is postoperative relapse, which rate varies widely within 3–54% between medical facilities. The genetic traits of recurrent liver echinococcosis comprise an important subject of research into its etiopathogenetic factors for an effective prognosis of cyst relapse and treatment personalisation.Materials and methods. Bashkir State Medical University (Ufa, Russia) provided facilities to study targeted chemoprophylaxis efficacy in a case of relapsed liver echinococcosis with haplotype CYP1A2F1*A/A (AA) and the UM phenotype of ultrarapid albendazole sulfoxide­to­albendazole sulfone metaboliser.Results and discussion. The clinical case presented illustrates the rationale behind personalised chemoprevention of recurrent echinococcosis with albendazole based on genotyping data. Genotyping allows detection of an ultrafast metaboliser haplotype in blood implicating a rapid degradation of administered albendazole, reduced antiparasitic impact of drug therapy and more feasible relapse, in contrast with a normal metaboliser phenotype.Conclusion. A successful secondary prevention of relapsed echinococcosis suggests the efficacy of personalising albendazole­based chemoprophylaxis of recurrent echinococcosis with genotyping data.

Keywords

• эхинококкоз печени
• паразитарные болезни печени
• таргетная терапия
• альбендазол
• бензимидазолы
• рецидив
• генетические исследования