Hepatitis B and C viral infections in Tihamet Aseer, south-western Saudi Arabia: Are there gender differences?

Background: Hepatitis B virus (HBV) infection is endemic in Saudi Arabia. Many studies have shown varying results in gender differences in HBV and hepatitis C virus (HCV) infection. The objective of this study was to determine if gender differences exist in HBV and HCV infection and to elucidate any related risk factors in Tihamet Aseer, south-western Saudi Arabia. Materials and Methods: The study was a cross-sectional study of a representative sample of males and females in Tihamet Aseer, south-western Saudi Arabia. A comprehensive questionnaire was completed by all participants. Blood samples were taken and sera were tested for hepatitis B surface antigen and HCV antibodies by fourth-generation enzyme immunoassays. Results: The study included 1532 participants from the Tihamet Aseer area. An overall seroprevalence of 7.9% and 1.7% was found for HBV and HCV infections, respectively. In logistic regression analysis, no gender differences were found for HBV seroprevalence. Identified risk factors for HBV infection included a history of blood transfusion and lack of hepatitis B vaccination. On the other hand, females were more prone to become seropositive for HCV (adjusted odds ratio = 5.034, 95% confidence interval: 1.042–9.321). Other identified risk factors for HCV infection were illiteracy and a history of blood transfusion. Conclusion: The prevalence and HBV and HCV infection is high compared to the national figures. Gender differences were only observed in HCV infection. It is recommended to have an active educational and media campaign. A “catch-up” vaccination program against HBV should be introduced for adults as a strategy to achieve the herd immunity effect in the affected area

The risk of acquiring hepatitis B and C viral infections following tooth extraction in Al Farsha area, south-western Saudi Arabia

AbstractThe objective of this work was to study tooth extraction as a potential risk factor for the seroprevalence of HBV and HCV infections and other related risk factors in Al Farsha area (a low deprived area), south western Saudi Arabia. Patients and their relatives attending the outpatients’ clinics of Al Farsha hospital and relevant primary health care centers were included. A comprehensive questionnaire interview was offered to all participants. Blood samples were taken and tested for HBsAg and HCV antibodies. The present study included 395 persons. Sero-prevalence of HBV and HCV amounted to 15.2% and 2%, respectively. Tooth extraction was found to be a significant risk factor in the transmission of both HBV and HCV infections (aOR=2.363, aOR=3.253, respectively). Persons lacking hepatitis B vaccination were also at a higher risk of acquiring HBV infection. There is an urgent need to introduce effective health education campaign and catch-up vaccination against HBV infection in the region. Infection-control education programs tailored to the need of the local health force should be promptly provided. Furthermore, curricula of the local dental colleges must be reviewed to introduce, at an early stage, infection control preventive measures in order to interrupt the transmission of blood-borne infections in general

Endoscopic treatment of biliary leak following gunshot injury: A case report

This report describes the endoscopic treatment of a biliary leak, following a gunshot injury to the liver of a young Saudi female. She was admitted to the emergency unit having sustained an accidental gunshot on the upper part of her right shoulder when her spouse was maintaining his gun sitting on a higher level chair. She was intubated and immediately taken for exploratory laparotomy, which revealed right liver lobe laceration and significant hemoperitoneum. Bleeding was controlled surgically, and two peritoneal lavage catheters were inserted for drainage. However, about 300–400 ml of bile drainage was observed daily. Accordingly, endoscopic retrograde cholangiopancreatography (ERCP) was performed, which demonstrated a biliary leak. Sphincterotomy was performed and a stent was inserted, following which the biliary leak eventually subsided. A follow-up ERCP was performed 10 weeks later, and no further leak was observed. This is the first case report of a successful endoscopic treatment of traumatic biliary injuries due to a gun shot in Saudi Arabia. ERCP is a valuable method in the treatment of a traumatic bile leak. This report describes the endoscopic treatment of a biliary leak following a gunshot injury in a young Saudi female. She was admitted to the emergency unit having sustained an accidental gunshot on the upper part of her right shoulder when her spouse was maintaining his gun sitting on a higher level chair. She was intubated and immediately taken for exploratory laparotomy, which revealed right liver lobe laceration and significant hemoperitoneum. Bleeding was controlled surgically, and two peritoneal lavage catheters were inserted for drainage. However, about 300–400 ml of bile drainage was observed daily. Accordingly, endoscopic retrograde cholangiopancreatography (ERCP) was performed, which demonstrated a biliary leak. Sphincterotomy was performed and a stent was inserted, following which bile drainage gradually reduced, and stopped after 5 days. A follow-up ERCP was performed 10 weeks later, and no further leak was observed. This is the first case report of a successful endoscopic treatment of traumatic biliary injury due to a gunshot in Saudi Arabia. ERCP is a valuable method in the treatment of a traumatic bile leak

Seroprevalence of HBsAg among adolescents and adults in the Muhayil Aseer region of KSA: 25 years after the introduction of national vaccination

AbstractObjectiveThe objective of this work was to investigate the seroprevalence and associated risk factors of HBsAg among adolescents and adults in the Muhayil Aseer region of KSA.MethodsA cross-sectional study was conducted on a selected sample of adolescents and adults in the Muhayil Aseer region of KSA. A comprehensive questionnaire-based interview was performed for all participants, blood samples were taken, and sera were tested for HBsAg.ResultsThe study included 133 adolescents and 938 adults. A seroprevalence of 1.5% and 6.1% were recorded among adolescents and adults, respectively. The study showed that persons without the hepatitis B vaccination carried a significantly higher risk for developing sero-positivity for HBsAg.ConclusionThe present study further endorsed the effectiveness of vaccination in preventing hepatitis B virus (HBV) infection. Strict preventive measures against HBV infection need to be fostered in the study area

Hepatitis C Virus Infection at Primary Healthcare Level in Abha City, Southwestern Saudi Arabia: Is Type 2 Diabetes Mellitus an Associated Factor?

Background: There is an increasing concern about the relation between hepatitis C virus infection (HCV) and type 2 diabetes mellitus (T2DM). The present study aims to determine the prevalence of HCV infection among T2DM patients and non-diabetic patients attending primary healthcare centers (PHCCs) in Abha city, southwestern Saudi Arabia, and to explore the possible association between T2DM and HCV infection. Methods: A cross-sectional study targeting a random sample of T2DM and non-diabetic patients attending PHCCs in Abha City was conducted. Patients were interviewed using a structured questionnaire and screened for HCV infection using fourth-generation ELISA kits. All positive cases were confirmed by qualitative RT-PCR immune assay. Results: The study revealed an overall seroprevalence of HCV infection of 5% (95% CI: 2.9–7.9%). Among T2DM and non-diabetics, a seroprevalence of 8.0% and 2.0% was found, respectively. Using multivariable regression analysis, the only significant associated factor for HCV infection was T2DM (aOR = 4.185, 95% CI: 1.074–16.305). Conclusions: There is strong positive association between T2DM and HCV infection. Yet, the direction of relationship is difficult to establish. Patients with T2DM have higher prevalence of HCV infection than non-diabetic group. It is highly recommended for primary health care providers to screen for HCV infection among T2DM patients and to increase the level of HCV awareness among them