Chronic Hepatitis C in Saudi Arabia: Three Years Local Experience in a University Hospital

Abstract

BackgroundChronic hepatitis C (CHC) is a global infection. In Saudi Arabia, the prevalence of CHC is declining due to the implementation of a blood screening program. However, CHC still remains a leading cause of liver cirrhosis and hepatocellular carcinoma.ObjectivesThis is a retrospective study of CHC patients at the King Abdul Aziz University Hospital, Jeddah, Saudi Arabia.Patients and MethodsOut of a total of 291 CHC patients from the hepatology clinic at King Abdul Aziz University hospital, Jeddah, 279 patients were included in the present study. They were primarily male (152, 54.5%), with a mean age of 50.41 ± 1.72 years. The majority of patients were either Saudi (108, 38.7%) or Egyptian (60, 21.5%). A total of 61 patients received combination treatment with pegylated interferon and ribavirin, and one patient with sickle-cell anemia received pegylated INF monotherapy. Demographic, clinical and laboratory features of the CHC patients, and their responses to treatment were studied.ResultsDecompensated cirrhosis was documented in 60 patients (21.5%), and hepatocellular carcinoma in 14 (5%). The mean level of serum alanine aminotransferase was 83.6 ± 231 u/L. The predominant genotype among the 70 patients tested, was genotype 4, followed by genotype 1 (39 and 18 patients, respectively). The sustained viral response (SVR) rate was 82.99%. The main predictive factors for SVR were baseline HCV viral load and rapid virologic response (RVR). The mean duration of follow-up was 4.2 ± .85 years. There were 24 patients who had liver disease-related mortality.Conclusionsour data showed that 22% of CHC patients progress to cirrhosis and another 22% had treatment. Liver related mortality was more common in patients with advanced cirrhosis.

Clinical Complications of Hemoglobinopathies in Western Saudi Arabia and the Need for Specialized Care Centers

“…Given that patients may receive transfusions in diff erent hospitals during the course of their disease, and in the absence of a national database for patients with hemoglobinopathies on regular transfusion, it is diffi cult to determine whether HCV seroconversion occurred before or after introduction of nucleic acid testing on a national level. In fact, patients with hemoglobinopathies constitute the largest fraction of patients with HCV who have an identifi able risk factor in our institution [26] Overall these fi ndings highlight the need for better compliance without patient visits and more rigorous screening to allow early referrals to specialists, early initiation of therapy, and identifi cation of associated risk factors.…”

Meta-analysis

“…Eighty-four studies were closely evaluated for eligibility[10–16, 18, 26–101]. Fourteen studies did not have extractable treatment outcomes data[26, 29, 36, 47, 50, 58, 61, 64, 74, 86, 87, 92, 100, 101]. Six were redundant[49, 51, 57, 68, 89, 99] and four were not relevant[30, 43, 60, 94].…”

Hepatitis C virus infection in southwestern Saudi Arabia: Are we still in the plateau phase?

“…It is worth noting that most of the HCV studies and data analysis conducted in Saudi Arabia were targeting selected groups such as blood donors [Ahmed et al, 1995;Al-Knawy et al, 1995;Shobokshi et al, 2003;Abdullah, 2013;Elbjeirami et al, 2015] and patients on hemodialysis [Al Shohaib et al, 1995;Karrar, 2007]. Similarly, researchers in Saudi Arabia also studied cases with chronic liver disease and hepatocellular carcinoma [Ayoola et al, 1992;al-Faleh and Ramia, 1997;Akbar, 2004;Akbar et al, 2012], while community-based studies are scanty and even lacking.…”