Chronic active hepatitis at Baragwanath Hospital

In a retrospective analysis of 35 Black patients with chronic active hepatitis (CAH) admitted to Baragwanath Hospital, Johannesburg, during the period 1972-1980, four major aetiological categories were found: auto-immune (lupoid, immunological (57%», drug-induced (isoniazid and a-methyldopa (17%», heptatitis B virus-related (14%), and alcohol-related (11%) CAH. Alcohol-related CAH was found in males only. Upper abdominal pafn was a presenting feature of alcohol-induced CAH, while jaundice was a common. presenting feature of the other types. Systemic features such as skin rashes (acne, urticaria), bacterial infections and congestive cardiac failure were prominent in the auto-immune type of CAH. The liver was enlarged in the majority of cases. Hepatitis B virus-related CAH showed an absence of tissue nonspecific auto-antibodies. Cirrhosis was present in approximately 50% of patients at the time of diagnosis. Despite the facts that isoniazid and a-methyldopa are commonly used and hepatitis B infections and alcohol abuse are 'frequent in this population, CAH. remains an uncommon condition in South African Blacks

Selected risk factors for coronary heart disease in male scholars from the major South African population groups

A num.ber of risk factors for coronary heart disease (CHD) in 7 groups of South African male scholars aged between 15 and 20 years were surveyed. Selection of the groups was based on socioeconomic status and comprised urban and rural blacks, Indians of higher and lower socio-economic status, coloureds of higher and lower socio-economic status, and middle-class whites. Both Indian groups, both coloured groups and the whites had a much greater prevalence and severity of CHD risk factors than the two black groups. This held for total cholesterol, low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC), the HDLC/LDLC ratio, apolipoprotein B, apolipoprotein A-I, insulin, fibrinogen and mass. One exception was lipoprotein a, levels of which were higher in both black groups. In general the CHD risk factor profile was worse in the higher socio-economic groups, and it also tended to be worse in urban than in rural blacks. These findings stress the need to reduce CHD risk factors in our developed populations and to prevent their emergence in our developing peoples