Characteristic of Autoimmune Hepatitis in Mukalla-Hadhramount a Five-Year Retrospective Study from Resources-Limited Setting

Abstract

Nabeel Salem Musean, Ahmed Mubarak Daakeek, Hana Webair and Ali Ahmed Al-Zaazaai

Background & Aim: Autoimmune hepatitis (AIH) is an immune-mediated liver disease prevalent in young adults, predominantly affecting women. This study aimed to investigate the clinical characteristics of AIH in Hadhramout Governorate, Yemen, where data on this condition is limited.

Methods: This retrospective analysis examined medical records of patients diagnosed at Al-Amal Medical Center in Mukalla, Hadhramout, between 2019 and 2013. Diagnosis of AIH based on specific criteria according to our resources based on interna- tional AIH criteria. Data collected included demographics, clinical presentation, laboratory findings, radiological results, and social habits, particularly khat chewing. Patients were classified into AIH types 1 and 2, and treatment responses were assessed.

Results: Twenty-five of the 27 diagnosed AIH patients were included in the study. The mean age of the patients was 25.76 ±3.018 years, with a male predominance of 92%. Ninety percent of the patients were khat chewers. Acute hepatitis and jaundice were the most frequent presentations, observed in 88% of cases. Type 1 AIH was diagnosed in 76% of patients.

Discussion: Prednisolone treatment resulted in complete remission in 88% of patients. However, patients with advanced disease showed poorer treatment outcomes (p=0.00). Three patients experienced a relapse of the disease, and two patients died from liver cirrhosis.

Conclusion: In Hadhramout, AIH primarily affects young khat-chewing males, contrasting global trends. While most patients responded well to treatment, those with advanced disease had poorer outcomes.

PDF