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Chronic hepatitis C in saudi arabia: three years local experience in a university hospital
Hisham O Akbar1, Ahmad Al Ghamdi, Faten Qattan
1Department of Internal Medicine, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia.
Insights
Chronic hepatitis C (CHC) patients in Saudi Arabia show high sustained viral response rates to treatment. Advanced cirrhosis significantly increases liver-related mortality risk in these patients.
Area of Science:
- Hepatology
- Infectious Diseases
- Gastroenterology
Background:
- Chronic hepatitis C (CHC) remains a significant global health concern, contributing to liver cirrhosis and hepatocellular carcinoma.
- While Saudi Arabia has seen a decline in CHC prevalence due to blood screening, it still poses a substantial public health challenge.
- Understanding treatment outcomes and disease progression in the Saudi CHC population is crucial for effective management.
Purpose of the Study:
- To retrospectively analyze the demographic, clinical, and laboratory features of CHC patients treated at King Abdul Aziz University Hospital, Jeddah.
- To evaluate the treatment response, specifically sustained viral response (SVR), in CHC patients.
- To identify factors influencing treatment outcomes and assess the progression of liver disease, including cirrhosis and mortality.
Main Methods:
- Retrospective analysis of 279 CHC patients from a hepatology clinic.
- Data collection included patient demographics, clinical status, laboratory results, and treatment regimens (pegylated interferon and ribavirin).
- Assessment of sustained viral response (SVR), viral load, and liver disease progression, including cirrhosis and hepatocellular carcinoma.
Main Results:
- The study included 279 CHC patients, predominantly male, with a mean age of 50.41 years.
- Decompensated cirrhosis was observed in 21.5% of patients, and hepatocellular carcinoma in 5%.
- A high sustained viral response (SVR) rate of 82.99% was achieved, with baseline HCV viral load and rapid virologic response (RVR) being key predictors.
Conclusions:
- The study demonstrates a high SVR rate in CHC patients treated with combination therapy, highlighting treatment efficacy.
- Approximately 22% of CHC patients progressed to cirrhosis, and liver-related mortality was higher in those with advanced cirrhosis.
- These findings underscore the importance of early diagnosis and treatment to prevent advanced liver disease and mortality in CHC patients.
Background:
Chronic 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.
Objectives:
This is a retrospective study of CHC patients at the King Abdul Aziz University Hospital, Jeddah, Saudi Arabia.
Patients And Methods:
Out 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.
Results:
Decompensated 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.
Conclusions:
our 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.
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