Noninvasive diagnosis of liver fibrosis in schistosomiasis japonica: Opportunities and challenges

To the Editor,Schistosomiasis is an infectious disease caused by trematode parasites of the genus Schistosoma.According to the World Health Organization(WHO),it is estimated that about 250 million people in the world are infected with the disease,nearly 800 million people are at risk of infection,and more than 200,000 people die of schistosomiasis every year.1,2 In China,the endemic species of schistosome that primarily infects humans is Schistosoma japonicum.Schistosomiasis japonica has been a major public health problem affecting human health and economic development in the past decades.The latest national epidemiological data showed that there were still 29,517 advanced cases of schistosomiasis japonica at the end of 2020.Moreover,approximately 842,500 patients had been previously infected with S.japonicum nationwide,of whom 83.3%had chronic schistosomiasis.3 Our previous studies confirmed that past cases have no possibility of re‐infection after antiparasitic treatment and that liver fibrosis continues to progress and eventually develops into advanced schistosomiasis.4 Some studies have also shown that although chemotherapy with praziquantel is readily available and has good efficacy,liver fibrosis remains the most serious consequence of S.japonicum chronic infection,with an incidence of nearly 20%in infected patients.5 Hence,nearly one million patients with chronic schistosomiasis are at risk of later developing liver fibrosis.