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 alpha-methyldopa (17%)), hepatitis B virus-related (14%), and alcohol-related (11%) CAH. Alcohol-related CAH was found in males only. Upper abdominal pain 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 alpha-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.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006521:Hepatitis, Chronic / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013019:South Africa