Clonorchis sinensis is the most common human liver fluke in East Asia. Several studies proved its
carcinogenesis in humans and it was reclassified as a group 1
biological carcinogen in 2009. It is still actively transmitted in endemic areas of Korea, China, Russia, and Vietnam. Currently it is estimated that more than 200 million people are at risk of
infection, 15-20 million people are infected and 1.5-2 million show symptoms or complications. Several molecules and genes of the fluke have been identified and characterized. Studies on its
oncogenesis and omics-based findings have been especially encouraging. Diagnosis of its
infection depends mainly on detection of eggs in feces but other methods have been developed. ELISA using
crude extract antigen is now popular for its diagnosis. Diagnosis by detecting DNAs from eggs in feces has been developed using PCR, real-time PCR, and LAMP, which have been found sensitive and specific. Imaging diagnosis has been studied in depth and is widely used. Any evidence of
clonorchiasis, such as eggs, DNAs, or images, may lead to recommendations of
chemotherapy in endemic areas.
Praziquantel is the major chemotherapeutic agent for
clonorchiasis and recently
tribendimidine was found effective and is now under investigation as a promising chemotherapeutic alternative. Sustainable control programs which include mass
chemotherapy with
praziquantel and education for prevention of
re-infection may reduce its morbidity and eliminate its
infections in endemic areas.