Evaluating periportal fibrosis in schistosomiasis mansoni using the ELF [Enhanced Liver Fibrosis] score: A pilot study.

Authors

Rebecca Dantas Thorp, Andrea Dória Batista, Carolline A Mariz, Lilian Rose Maia Gomes de Araújo, George Tadeu Nunes Diniz, Ana Virgínia Matos Sá Barreto, Clarice Neueschwander Lins de Morais, Paula Carolina Valença Silva, Ana Lúcia Coutinho Domingues, Edmundo Pessoa Lopes

Published in

PLoS neglected tropical diseases. Volume 20. Issue 10. Pages e0014775. Oct 09, 2026. Epub Oct 09, 2026.

Abstract

Measuring the periportal fibrosis pattern (PPF) in schistosomiasis mansoni (SM) is essential for diagnosing portal hypertension. The Enhanced Liver Fibrosis (ELF) test can be used to quantify liver fibrosis, however, few studies have been done in SM. This study evaluated serum ELF value according to the PPF pattern established by the Niamey ultrasound classification (US) and history of upper gastrointestinal bleeding (UGIB) in patients with SM.
A cross-sectional, bidirectional analytical study was carried out with patients from an endemic area and from a reference outpatient clinic for SM. A structured questionnaire was applied to collect sociodemographic and clinical data, and blood samples were collected for ELF determination. US was performed by the same examiner.
Among the 196 patients evaluated (58% women; mean age of 45.04 years ± 15.30 years) 18 (%) presented with Niamey US pattern A + B; 64 (%) pattern C; 56 (%) pattern D; 49 (%) pattern E and 9 (%) pattern F. The median ELF values were higher the greater the PPF intensity: 8.36 in A + B; 8.40 in C; 8.64 in D; 8.99 in E and 9.75 in F Niamey pattern (p = 0.0021). There was no difference in the mean ELF serum value between patients with and without history of UGIB. The ELF was able to differentiate patients without PPF, with mild, moderate and advanced PPF: A + B vs C vs D vs E + F (p = 0.0024), as well as patients with advanced PPF from those without fibrosis or with moderate fibrosis: A + B vs E + F (p = 0.0464) and C + D vs E + F (P = 0.0007).
The ELF test demonstrated potential as a tool for assessing PPF in SM patients, as it could differentiate those with minimal fibrosis from those with moderate or advanced fibrosis.

PMID:
42853889
Bibliographic data and abstract were imported from PubMed on 10 Oct 2026.

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