Profiles of autoimmune hepatitis in Brunei Darussalam. 2009

Anand Jalihal, and Pemasari Upali Telisinghe, and Vui Heng Chong
Gastroenterology Unit, Department of Medicine, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Bandar Seri Begawan BA 1710, Brunei Darussalam.

BACKGROUND Autoimmune hepatitis (AIH) is a chronic inflammatory disease of the liver. Data on the disease remain scarce in the Southeast Asia region. This study was undertaken to assess the profiles of AIH in Brunei Darussalam. METHODS Nineteen patients with AIH treated at the hepatology clinic, RIPAS Hospital (up until December 2008) were reviewed. Demographic, laboratory, histologic, clinical, and therapeutic data of the patients were collected. RESULTS The median age of the 19 patients at diagnosis was 52 years (range 33-70) with a male to female ratio of 1:3.75. All patients were diagnosed with type I AIH. The prevalence rate of the disease was 5.61/100 000 and was higher in the Chinese than in Malays and Indigenous people. Commonly seen presentations were abnormal liver function (52.6%), icteric hepatitis (36.8%), and decompensated liver disease (10.5%). Histologically advanced fibrosis was found in 47.4% and cirrhosis in 21.1% of the patients. Immune-mediated diseases were present in 36.8%. In a follow-up for 31 months (range 0.25-102), three patients died, 2 had progressive liver failure and 1 had lymphoma. Complete biochemical response was seen in 75% of the patients, partial response in 12.5%, and no response in 12.5%. HLA DRB1*03 (DR3) was detected in 18.2% of the patients and DRB1*04 (DR4) in 45.5%. There were significant associations between HLA Cw7 (P=0.038) and DQB1*04 (P=0.007). CONCLUSIONS The data of the 19 patients were comparable to those reported in the literature. Most of the patients were found to have abnormal biochemistry. There were significant associations between HLA Cw7 and DQB1*04, but not between DRB1*03 (DR3) and DRB1*04 (DR4).

UI MeSH Term Description Entries
D008099 Liver A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances. Livers
D008111 Liver Function Tests Blood tests that are used to evaluate how well a patient's liver is working and also to help diagnose liver conditions. Function Test, Liver,Function Tests, Liver,Liver Function Test,Test, Liver Function,Tests, Liver Function
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002010 Brunei An independent sultanate on the northeast coast of Borneo. Its chief products are oil and natural gas. Its name is Hindi, coming from the Sanskrit bhumi, land or region. It gave its name Brunei to Borneo. (From Webster's New Geographical Dictionary, 1988, p183 & Room, Brewer's Dictionary of Names, 1992, p82)
D005260 Female Females
D006680 HLA Antigens Antigens determined by leukocyte loci found on chromosome 6, the major histocompatibility loci in humans. They are polypeptides or glycoproteins found on most nucleated cells and platelets, determine tissue types for transplantation, and are associated with certain diseases. Human Leukocyte Antigen,Human Leukocyte Antigens,Leukocyte Antigens,HL-A Antigens,Antigen, Human Leukocyte,Antigens, HL-A,Antigens, HLA,Antigens, Human Leukocyte,Antigens, Leukocyte,HL A Antigens,Leukocyte Antigen, Human,Leukocyte Antigens, Human
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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