Biochemical Alterations in Liver Function Parameters among Entamoeba Histolytica–Positive Patients at Al-Bayda Medical Center, Libya

Abstract

Entamoeba histolytica infection remains a major public health problem in endemic regions and may lead to extraintestinal complications, particularly hepatic involvement. While amoebic liver abscess is well recognized, biochemical alterations in liver function among E. histolytica–positive patients without clinically evident hepatic disease remain insufficiently characterized. This study aimed to evaluate liver function parameters and their interrelationships among patients diagnosed with Entamoeba histolytica at Al-Bayda Medical Center, Libya. A laboratory-based cross-sectional study was conducted in 2025 and included 30 patients with confirmed E. histolytica infection. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin, and direct (conjugated) bilirubin were measured using routine clinical chemistry methods. Data distribution was assessed using the Shapiro–Wilk test. One-sample t-tests or Wilcoxon signed-rank tests were applied to compare observed values with reference limits, and Spearman’s rank correlation analysis was used to assess associations among biochemical parameters. Elevated aminotransferases were common, particularly AST (56.7%) and ALT (40.0%), indicating frequent hepatocellular stress. In contrast, elevations in ALP (36.7%) and direct bilirubin (30.0%) were less frequent, while total bilirubin elevation was rare (6.7%). Strong positive correlations were observed among ALT, AST, and ALP, whereas total and direct bilirubin were strongly correlated with each other but showed weak associations with liver enzymes. In conclusion, Entamoeba histolytica infection was associated predominantly with hepatocellular enzyme alterations, with minimal disruption of bilirubin metabolism. Routine liver function testing may aid in the early detection of hepatic involvement in amoebiasis, even in the absence of overt liver disease