Background and study aim: Regarding the increased number of chronic liver diseases (CLD) patients suffering from ‎many manifestations e.g. diarrhea, this withdrew our attention to try to find a relation ‎between CLD and parasitic infections in those patients‎.
Patients and Methods: A case-control study was performed on 190 participants suffering from gastrointestinal ‎complaints especially diarrhea attending Gastroenterology and Hepatology Outpatient ‎Clinics at Zagazig University Hospital, divided into 2 groups GI: 95 CLD patients. GII: 95 ‎non-CLD Control group patients. Cases underwent clinical, abdominal ultrasonographic, ‎and laboratory liver function assessments. Also, collected patients' stool samples were ‎microscopically examined using iodine, Trichrome and Modified Ziehl-Neelsen stains. To ‎confirm accurate diagnosis to parasitic infections causing diarrhea, RIDA-ELISA for ‎Cryptosporidium spp. and Giardia lamblia copro-antigens detections was performed.
Results: Parasitic infections among both studied groups were (47%), comprising (58%) in CLD and ‎‎(36%) in non-CLD as follow: Cryptosporidium (28%, 14%), Giardia (15%, 12%), mixed ‎‎(5%, 3%), E.histolytica spp. (5%, 4%), Blastocystis hominis (3%, 1%) and H. nana (1%, ‎‎2%) respectively. The sensitivity, specificity, PPV, NPP and accuracy of ELISA regarding ‎Giardia and Cryptosporidium infections were (100% and 89.6%, 97.5% and 100%, 87.9% ‎and 100%, 100% and 96.6%, 97.9% and 98.4%) respectively. In GI, most giardial cases ‎had normal ALT and AST levels (74%, 63%), but elevated in cryptosporidial infection ‎‎(59%, 66%) respectively, with statistically significant difference‎.
Conclusion: Presence of intestinal parasitic infections; mainly Cryptosporidia and Giardia protozoa ‎among CLD patients was striking when compared to diarrheic non-CLD control group and ‎this may be attributed to impaired immune status.