Impact of Entamoeba histolytica Infection on Liver Function: Analysis of AST, ALT, ALP, and Bilirubin Levels Among Patients at Al-Bayda Medical Center, Libya, 2025.

ABSTRACT:

Entamoeba histolytica is a protozoan parasite causing amebiasis, which may involve the liver and lead to hepatocellular injury and biliary disturbances. This cross-sectional study evaluated the effect of E. histolytica infection on liver function among 50 patients attending Al-Bayda Medical Center, Libya, in 2025. Infection was determined using stool microscopy, with 30 patients testing positive and 20 negative. Serum liver function markers—alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin (TB), and direct bilirubin (DB)—were analyzed using automated clinical chemistry systems. Normality was assessed with the Shapiro-Wilk test, and differences between groups were analyzed using the Wilcoxon rank-sum test, with effect sizes calculated to determine the magnitude of changes. Results showed significant elevations in ALT (47.2 ± 36.1 U/L vs. 12.4 ± 7.8 U/L; r = 0.804), AST (41.6 ± 16.2 U/L vs. 20.3 ± 10.2 U/L; r = 0.760), and ALP (144.0 ± 58.0 U/L vs. 88.2 ± 23.6 U/L; r = 0.550) in infected patients, indicating hepatocellular injury and possible cholestatic involvement. Total and direct bilirubin levels differed minimally, suggesting preserved bilirubin metabolism in most patients. These findings highlight the importance of monitoring liver function in patients with suspected or confirmed E. histolytica infection. Elevated hepatocellular enzymes may serve as early indicators of hepatic involvement, facilitating timely diagnosis and clinical management. This study provides insights into the biochemical impact of E. histolytica in a Libyan clinical setting and emphasizes the need for further research using imaging and molecular diagnostics for comprehensive hepatic assessment.

Keywords: Entamoeba histolytica; amebiasis; liver function tests; hepatocellular injury; Al-Bayda, Libya.