Prevalence and Clinical Characteristics of NAFLD in Chronic Liver Disease Patients from King Abdulaziz University Hospital, Jeddah.

Background: Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease (CLD). NAFLD is also related to obesity and metabolic syndromes, which are common in Saudi Arabia. However, it is yet unclear what proportion of CLD cases is because of NAFLD in Saudi Arabia.

Analysis of Hepatitis B virus (HBV) mutations in patients from Western Saudi Arabia with chronic disease.

Introduction: Extensive research has provided a link between HBV variants and the clinical complications of liver diseases. This study was performed to further investigate the relationship between HBV variants in preS, S and BCP/PC regions and disease progression in chronic hepatitis B (CHB) cases in Jeddah, Saudi Arabia.

Methodology: 182 CHB patients were recruited for this study.

Prevalence and molecular characterization of hepatitis D virus in Saudi Arabia: A single-center study.

Background/aims: Hepatitis D virus (HDV) is a defective RNA virus that is dependent on hepatitis B surface antigen (HBsAg) for transmission and replication. HDV significance arises from the possibility of poor prognosis of hepatitis B virus (HBV) infection. In Saudi Arabia, HDV prevalence varied from 8 to 32% before the HBV vaccination program and ranged from 0 to 14.

Fibroscan Compared to FIB-4, APRI, and AST/ALT Ratio for Assessment of Liver Fibrosis in Saudi Patients With Nonalcoholic Fatty Liver Disease.

Background: Nonalcoholic fatty liver disease (NAFLD) is being increasingly recognized as a cause of chronic liver disease. It has also been associated with devastating outcomes such as decompensated liver cirrhosis and hepatocellular carcinoma, as well as diabetes and metabolic syndrome.

Objectives: This study was conducted in order to assess liver fibrosis using Fibroscan, and to compare these results to the use of Fibrosis-4 (FIB-4) scores, AST platelet ratio index (APRI scores), and the AST/ALT ratios on NAFLD patients.

Autoimmune hepatitis as a unique form of an autoimmune liver disease: immunological aspects and clinical overview.

Autoimmune hepatitis (AIH) is a unique form of immune-mediated disease that attacks the liver through a variety of immune mechanisms. The outcomes of AIH are either acute liver disease, which can be fatal, or, more commonly, chronic progressive liver disease, which can lead to decompensated liver cirrhosis if left untreated. AIH has characteristic immunological, and pathological, features that are important for the establishment of the diagnosis.

Chronic hepatitis C in saudi arabia: three years local experience in a university hospital.

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.

Variceal hemorrhage: Saudi tertiary center experience of clinical presentations, complications and mortality.

Aim: To determine the clinical presentation, underlying etiology and short- and long-term outcomes of acute variceal bleeding (AVB).

Methods: A retrospective descriptive cohort study of cirrhotic patients with AVB who were admitted to King Abdul Aziz University Hospital between January 2005 and December 2009. We obtained demographic data for all patients.

Autoimmune liver disease - are there spectra that we do not know?

Autoimmune liver diseases (AILDs) are common leading causes for liver cirrhosis and terminal stage of liver disease. They have variable prevalence among patients with liver disease and have two major clinical and biochemical presentations. Autoimmune hepatitis (AIH) is the typical example of hepatocellular AILD, but it can also be presented under a cholestatic pattern.

Mycophenolate mofetil as a rescue therapy for autoimmune hepatitis patients who are not responsive to standard therapy.

Autoimmune hepatitis (AIH) is a chronic liver disease of unknown etiology that is responsive to steroid and azathioprine treatment in more than 80% of patients after 3 years of treatment. There are few alternative treatment options for individuals with AIH who are unresponsive to steroids and azathioprine, and research on this is limited to open-label studies of a variety of immunosuppressive agents that involve only small numbers of patients. Mycophenolate mofetil is one of the most frequently used alternative agents for the treatment of AIH patients not responsive to standard therapy.

Can chronic hepatitis C resolve spontaneously? Case report and review.

Chronic hepatitis C (CHC) is variably prevalent around the world and is usually a blood-borne infection. Most patients will have subclinical infection at the onset, but patients who develop acute hepatitis can spontaneously clear the virus upon immune activation. Up to 80% of CHC patients will progress to chronic infection.

Chronic hepatitis B infection in a hepatology clinic at a university hospital in Jeddah.

Introduction: The outcome of chronic hepatitis B (CHB) infection in a cohort of CHB patients at the hepatology clinics of King Abdul Aziz University Hospital in Jeddah was studied.

Methodology: The results of a complete blood count, prothrombin time, liver function test and hepatitis B virus polymerase chain reaction (HBV-PCR) performed over the previous two to five years of follow-up were reviewed. Results of abdominal ultrasound performed within the last year and the data on the treatment type, duration and resistance were also obtained.

Autoimmune hepatitis: Single-center experience of clinical presentation, response to treatment and prognosis in Saudi Arabia.

Background/aim: Autoimmune hepatitis (AIH) is a common cause of end-stage liver disease worldwide. It is a disease prevalent in children and adults, with female predominance and variable clinical presentations. AIH has favorable responses to steroids and immunomodulators.

Elevated serum immunoglobulin G levels in patients with chronic liver disease in comparison to patients with autoimmune hepatitis.

Background: Hypergammaglobulinemia is frequently observed in patients with chronic liver disease (CLD) of different causes. On the other hand, elevated levels of serum immunoglobulin G (IgG) are the best diagnostic marker for autoimmune hepatitis (AIH). Thus, the ability to distinguish AIH patients from patients with other liver disease, especially patients with advanced liver cirrhosis, is important since most AIH patients will a have favorable treatment response if diagnosed properly.

Intestinal tuberculosis and Crohn's disease: the dilemma of similarities and misdiagnosis.

Differentiating intestinal tuberculosis from Crohn's disease is one of the most difficult and challenging issues for the gastroenterologist, radiologist and pathologist. The final diagnosis of such cases may need the gathering of all clinical, endoscopic, radiological and pathological data. In the following report three cases of intestinal tuberculosis are described.

Is serum alanine transaminase level a reliable marker of histological disease in chronic hepatitis C infection?

Background: Approximately 20-30% of patients chronically infected with hepatitis C virus (HCV) have persistently normal alanine transaminase (PNALT) levels. These patients are described to have a mild degree of histological liver damage. We aimed to assess the histological liver changes in HCV patients with PNALT.

Hepatitis C virus infection in Saudi Arabia.

Infection with hepatitis C virus (HCV) is a common global cause of chronic liver disease, which is also true in Saudi Arabia. HCV prevalence in Saudi Arabia varies in different provinces being highest in the Western and Southern provinces. Most of the studies among blood donors documented a decrease in HCV prevalence, probably due to increase awareness and improved socioeconomic status.

Pattern of admission to hospitals during muslim pilgrimage (Hajj).

Objective: The pattern of medical conditions necessitating admission differs according to the weather condition in that particular year. Previous studies had been conducted during the hot weather, none over the last 10 years, were carried out during, the milder weather we are experiencing. The aim of this study is to establish the pattern of admission during this mild weather and to elucidate the possible risk factors.

Lamivudine in chronic hepatitis B virus.

Objective: To access the effect of one year treatment with Lamivudine, and its durability on patients with compensated chronic hepatitis B.

Methods: Thirty-six patients with hepatitis B surface antigen positive, hepatitis B virus deoxyribonucleic acid (DNA) positive, were treated with 100 mg Lamivudine daily for one year, irrespective of their liver enzymes level, alanine aminotransferase or hepatitis B envelope antigen status. Patients with normal alanine aminotransferase and negative hepatitis B virus DNA at the end of the treatment were responders and those with persistent response 16 weeks off treatment were considered having durable response.

Effect of induction therapy on Hepatitis C.

Objective: To assess the response to one month induction combination therapy using alpha interferon and Ribavirin on patients with chronic hepatitis C.

Methods: Eighty patients with naive compensated chronic hepatitis C (group A) were followed at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia from October 1996 through February 2000 received daily subcutaneous injection of alpha interferon -2b (Intron A 3 million units) plus Ribavirin 1-1.2 grams (induction) for one month followed by Intron A, 3 times a week together with daily Ribavirin (same dose) for 11 months.

Treatment of patients with chronic hepatitis C with normal liver enzymes.

Objective: This is a controlled prospective study to evaluate the efficacy of induction combination therapy using alpha-interferon and ribavirin in patients with chronic hepatitis C and persistently normal liver enzymes.

Methods: Forty-six patients with compensated liver disease tested positive for hepatitis C virus antibody between October 1998 and August 2000 at King Abdulaziz University Hospital and Al-Badriyah Towers, Jeddah Clinics, Jeddah, Kingdom of Saudi Arabia. Twelve patients had persistently normal liver enzymes for 6 months and 34 patients with abnormal liver enzymes (control).

Effect of pegylated interferon on non-responders and relapsers with interferon.

Objectives: To assess whether a combination of pegylated interferon (interferon conjugated with polyethylene glycol) and ribavirin can improve the response rate in patients with chronic hepatitis C who either did not respond to (Non-responders), or had relapsed after responding to (Relapsers) standard interferon and ribavirin combination therapy.

Patients And Methods: In this prospective study, 20 chronic hepatitis C patients (comprising 16 Non-responders and 4 Relapsers to previous treatment with alpha interferon and ribavirin), were treated with pegylated interferon-2b weekly and ribavirin daily for one year. Eleven patients had genotype 4, eight were of genotype 1 and one patient had genotype 3.

Significance of normal liver enzymes in patients with hepatitis C virus.

Background: Hepatitis C Virus (HCV) infection is a common universal problem especially in the Arab World.

Objective: To assess the significance of persistently normal liver enzymes in patients who were anti HCV positive and suggest the proper approach for this group of patients.

Method: 56 patients who were anti HCV positive with persistently normal liver enzymes for more than one year underwent liver biopsy to assess their liver histology after excluding other possible causes of chronic liver disease.

Chemoembolization in hepatocellular carcinoma.

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