Dear Editor, We greatly appreciate the insightful commentary on our article, “Liver Diseases: Perspectives from the Philippines” [1]. The perspective on the inclusion of schistosomiasis as a cause of liver disease in the Philippines is indeed valuable.
While our review focused on prevalent causes of liver diseases, we recognize the significance of schistosomiasis in the country's health landscape. Schistosomiasis, caused by Schistosoma sp., remains endemic in certain regions of the Philippines [2,3]. We acknowledge its impact on liver health due to the granulomatous inflammatory reaction and subsequent fibrosis associated with this parasitic infection.
However, it's essential to contextualize the current situation of liver disease morbidity and mortality in the Philippines. Although prevalent, schistosomiasis may not rank as a primary cause of liver disease on a national scale. In the clinical settings we encounter, schistosomiasis cases are comparatively fewer and are often managed effectively. The decreasing mortality rate of schistosomiasis over the years signifies commendable progress, yet we understand that localized cases, especially in endemic regions, might still pose a challenge [2,3]. Research exploring the burden of schistosomiasis-associated liver diseases is needed to ascertain and accurately assess its impact.
We acknowledge the possibility of coexistence with other liver diseases such as hepatitis B, alcohol-related liver disease, and NAFLD [4]. This intersection of etiologies has the potential to exacerbate liver damage [5]. Therefore, research is needed to delve into this interplay and explore potential management strategies. Developing guidelines that address the impact of schistosomiasis on liver health could offer a structured approach to tackling the impact of this infection on health.
There is a need to continue fostering awareness and understanding of liver diseases in the Philippines. We remain committed to highlighting various aspects of liver health and diseases while being mindful of each etiology's relative prevalence and impact. We thank the commentary for engaging in this important dialogue and underscoring the significance of schistosomiasis in the broader context of liver disease.
Declaration of interestsNone.
