The Association between Parasitemia and Liver Enzyme Alterations in Malaria Patients: ABO Blood Group as A Non-Contributory Factor

Selva  Aminizadeh; Elham  Shokri; Mehdi  Mohebali; Haleh  Hanifian; Salman  Zafari; Mahdi  Edalati; Saeed  Bahadory; Hossein  Hosseinifard; Mehdi  Nateghpoor

doi:10.18502/jad.v19i4.21207

Selva Aminizadeh Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Elham Shokri Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Mehdi Mohebali Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Haleh Hanifian Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Salman Zafari Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Mahdi Edalati Department of Laboratory Sciences, Paramedical Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
Saeed Bahadory Vice-Challenger of Treatment, Imam Hasan Hospital, Alborz University of Medical Sciences, Karaj, Iran
Hossein Hosseinifard Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
Mehdi Nateghpoor Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jad.v19i4.21207

Keywords: Malaria; Blood groups; Liver enzyme; Disease severity; Human

Abstract

Background: Malaria, a life-threatening parasitic disease, exhibits diverse clinical manifestations influenced by parasite species, host immunity, and treatment access. Emerging evidence suggests that individual biological factors, such as ABO blood group and liver enzyme status, may also affect disease severity. This study investigates the relationship between blood type, liver enzyme levels, and malaria severity in affected patients.

Methods: A case-control study was conducted on malaria patients at the National Malaria Laboratory, Tehran University of Medical Sciences, from May 2022 to October 2024. Blood samples were analyzed for ABO blood grouping and liver enzymes: alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP). Malaria severity was classified according to WHO criteria. Statistical analyses, including chi-square tests and logistic regression, evaluated associations between blood group, liver enzyme levels and disease severity.

Results: A total of 100 participants were included: 50 malaria-positive patients and 50 healthy controls, with a mean age of 38.10±16.40 years. Malaria patients showed significantly higher AST, ALT and ALP levels compared to controls (p= 0.001). No significant association was found between ABO blood group and liver enzyme levels in either group (p> 0.05). Liver enzyme levels correlated significantly with parasitemia (p< 0.001), with higher parasite loads linked to greater hepatic dysfunction.

Conclusion: This study highlights the significant impact of parasitemia levels on liver function in malaria patients, while the ABO blood group appeared unrelated to liver enzyme alterations. Liver enzyme profiles may serve as valuable biomarkers for assessing malaria severity and guiding clinical management.