Chronic blood-borne viral hepatitis in a tertiary hospital in Al-Baha, Saudi Arabia: epidemiology, liver enzyme correlations, and treatment outcomes

Abstract Background In Al-Baha viral hepatitis in clinical settings has not been adequately investigated. This study examined chronic HBV and HCV infections and treatment outcomes among patients at King Fahd Hospital in Al-Baha. Methodology: Patients records were retrieved anonymously for clinical, demographic, virological and biochemical data from January 2019 and December 2022. Results A total of 148 patients infected with HBV and/or HCV attended during the 4-year study period. The mean age was 49.6 ± 13.2 (20–88 years); 84 (56.8%) males and 64 (43.2%) females. A total of 119 (80.4%) were infected with HBV, 27 (18.2%) with HCV while only 2 (1.4%) had dual HBV/HCV infection. Higher HBV viral loads correlated with higher ALT levels (r = 0.317, p = 0.001). Higher HCV viral loads did not associate with higher ALT levels (r = 0.246, p = 0.23). Of all cases 144 were clinically characterized and encompassed 117 chronic HBV, 25 chronic HCV, 1 acute HCV and 1 dual HBV/ HCV infection. Forty-seven (32.6%) were HBeAg-negative chronic infections, 69 (47.2%) were HBeAg- undesignated chronic infections. Cirrhosis was present in 6% of HBV cases and 18.5% of HCV cases. Through the course of HBV treatment, patients treated with tenofovir alafenamide (n = 15) achieved viral load suppression in 93.3%, with ALT either maintained or normalized in most cases. Treatment with entecavir (n = 8) also resulted in undetectable or markedly reduced viral load with generally unchanging ALT levels. All 16 HCV patients achieved viral clearance after 12 weeks treatment course; sofosbuvir–daclatasvir (n = 14) was highly effective though 2 showed elevated post-treatment ALT. Single patients on glecaprevir/pibrentasvir and elbasvir/grazoprevir also achieved viral clearance. Conclusions Chronic HBV and HCV infections remain clinical challenges. Viral load of HBV but not that of HCV correlated with ALT. Tenofovir alafenamide, entecavir, and sofosbuvir/daclatasvir showed strong efficacy, though limited follow-up and small sample sizes restrict conclusions. Overall, treatment responses merit further investigation.