Clinical Scorecard: Epidemiological Study of Chronic Blood-Borne Viral Hepatitis in a Tertiary Care Facility in Al-Baha, Saudi Arabia: Associations with Liver Enzymes and Treatment Results

At a Glance

Key Highlights

• HBV remains a significant health problem in Saudi Arabia despite vaccination programs, with ongoing cases of cirrhosis, hepatocellular carcinoma, and liver-related deaths.
• HCV affects approximately 0.7% of the Saudi population with many untreated cases leading to risk of advanced liver disease.
• Regional epidemiological data from Al-Baha is limited; this study uses retrospective clinical data from 2019-2022 to assess prevalence, liver enzyme associations, and treatment outcomes.

Guideline-Based Recommendations

Diagnosis

• Chronic HBV defined by persistent HBsAg for ≥6 months or ongoing HBV DNA beyond acute phase.
• Chronic HCV defined by presence of anti-HCV antibodies and detectable HCV RNA with evidence of chronic hepatitis beyond 4–6 months.
• Use of ELISA and confirmatory immune assays for serological diagnosis.
• Quantitative PCR assays for HBV DNA and HCV RNA viral load measurement.

Management

• HBV vaccination as preventive measure; no vaccine available for HCV.
• Direct-acting antiviral (DAA) therapy recommended for HCV with >95% cure rates.
• Treatment decisions based on viral load, liver enzyme levels, and clinical assessment.
• Monitoring and managing complications such as cirrhosis and hepatocellular carcinoma.

Monitoring & Follow-up

• Regular liver function tests including ALT, AST, bilirubin, ALP, and GGT.
• Follow-up viral load testing to assess treatment response and sustained virological response (SVR).
• Clinical and biochemical monitoring for disease progression.

Risks

• Risk of progression to decompensated cirrhosis and hepatocellular carcinoma if untreated.
• Limited access to diagnosis and treatment increases risk of advanced disease.
• Incomplete treatment adherence and follow-up may affect outcomes.

Patient & Prescribing Data

Patients with confirmed chronic HBV or HCV infection attending King Fahd Hospital in Al-Baha region.

Data on antiviral regimens and baseline labs were complete for treated patients; however, treatment duration, adherence, and follow-up viral load data were incomplete due to retrospective study design.

Clinical Best Practices

• Implement mass HBV vaccination programs to reduce incidence.
• Ensure early diagnosis through serological and molecular testing to initiate timely treatment.
• Utilize direct-acting antivirals for HCV to achieve high cure rates.
• Maintain comprehensive patient records to monitor treatment adherence and outcomes.
• Conduct regular liver enzyme and viral load monitoring to guide management.
• Address regional disparities by improving access to diagnosis and treatment in under-investigated areas like Al-Baha.

References

• World Health Organization Hepatitis Factsheet
• Saudi Ministry of Health Hepatitis Data