Intrafamilial clustering of Helicobacter pylori infection in Saudi Arabia

AIM

To study the pattern of Helicobacter pylori infection among family members in the Saudi population.

METHODS

A cross-sectional, population-based, seroepidemiological study of family members was undertaken in a Saudi population using saliva H pylori immunoglobulin (Ig) G antibodies (Helisal kit).

RESULTS

A total of 42 families comprising 271 children and 84 parents were studied (355 subjects; mean age 23 years, SD 19 years) The overall frequencies of H pylori IgG antibodies in mothers, fathers and children were 67%, 64% and 23%, respectively. There was no significant difference in the infection rate between mothers and fathers, or between boys and girls. The infection rate among children increased when one or both parents were seropositive, and the infection rate among parents was proportionally related to the number of infected children per family. The frequency of H pylori antibodies was significantly higher in spouses of seropositive parents than in spouses of seronegative parents (45% compared with 19.2%).

CONCLUSIONS

These data confirm that the intrafamilial clustering of H pylori infection in Saudi Arabia occurs in a similar pattern to that described in the developed countries, and that living conditions and social conditions lead to person to person transmission of H pylori infection.

Hepatitis C Virus infection in Saudi Arab patients with B-cell non-Hodgkin's lymphoma

OBJECTIVE

The objective of the current study is to determine the prevalence of Hepatitis C virus infection in Saudi Arab patients with B-cell non-Hodgkin's lymphoma.

METHODS

Fifty-six unselected Saudi Arab patients with B-cell non-Hodgkin's lymphoma were tested for the presence of Hepatitis C virus antibodies using Elisa immunoabsorbant assay 2.0. Positive and indeterminate results were subjected to confirmatory testing using RIBA-Hepatitis C virus 2.0. Two control groups were utilized for comparison; the first is a group of randomly selected general medical patients and healthy blood donors; and the 2nd is a cohort of patients with hematological neoplasms other than B-cell non-Hodgkin's lymphoma. Patients with previous history of blood transfusion or liver disease were excluded from the study.

RESULTS

Twelve of the 56 B-cell non-Hodgkin's lymphoma patients (21%) tested positive for Hepatitis C virus antibodies. Only 3 out of 104 (3%) and 2 out of 41 (5%) patients tested positive for Hepatitis C virus antibodies in the first and 2nd control groups.

CONCLUSION

The results of this study indicate a higher prevalence of Hepatitis C virus infection in Saudi Arab patients with B-cell non-Hodgkin's lymphoma than in the control groups. The prevalence of Hepatitis C virus infection in the 2 control groups, in turn, seems to fall within the estimated prevalence in the general population.

Etiology of ascites and the diagnostic value of serum-ascites albumin gradient in non-alcohol liver disease

This study was designed to determine the different etiologies of ascites and the diagnostic value of serumascites albumin gradient (SAAG) in patients with ascites of non-alcoholic liver disease in Southern Saudi Arabia. A total of 132 patients with ascites (96 males and 36 females, mean age 58.8+/-15.9 years) were studied for the different causes of ascites. In 55 patients with liver disease and 22 patients with nonliver disease (malignancy and peritoneal tuberculosis), we compared SAAG with the three usual parameters of ascitic fluid biochemical analysis used in the differential diagnoses of ascites. The nonliver disease group showed higher ascitic fluid total protein (aTP) concentration (4.77+/-2.05 versus 1.98+/-1.56 g/dL), ascitic to serum ratio of total protein (a/sTP) concentration (0.75+/-0.43 versus 0.26+/-0.19), ascitic fluid lactic dehydrogenase (aLDH) level (565.4+/-353.4 versus 254.1+/-205.03 U/L) and a lower SAAG (0.6+/-0.30 versus 1.71+/-0.61). P7lt;0.0001 for all parameters. The positive predictive values for aTP, a/sTP, aLDH and SAAG to detect ascites due to liver disease were 68%, 76%, 67%, and 80%, respectively, while the negative predictive values were 96%, 96%, 84%, and 98%, respectively. Liver causes accounted for 69.7% of cases, followed by peritoneal tuberculosis 10.6%, malignancy 9.1%, congestive heart failure 7.6%, and nephrotic syndrome 3.0%. SAAG is a useful diagnostic parameter which can be used to separate ascites of liver disease (nonalcoholic) from other causes of ascites, with an efficiency of 91%. SAAG should replace the traditional parameters (aTP, a/sTP, and aLDH) used in the differential diagnosis of ascites. In our series, liver disease is the major cause of ascites, followed by peritoneal tuberculosis.

A second-generation method of genotyping hepatitis C virus by the polymerase chain reaction with sense and antisense primers deduced from the core gene

A second-generation method of genotyping hepatitis C virus (HCV) was developed by the polymerase chain reaction (PCR) with sense as well as antisense primers deduced from the core gene. HCV RNA specimens extracted from sera were reverse-transcribed and amplified with universal primers in the first round of PCR to obtain fragments of 433 base pairs representing nucleotides 319-751. In the second round of PCR, portions of PCR products were amplified separately with sense and antisense primers specific for each of the five common genotypes prevailing across the world, i.e., I/1a, II/1b, III/2a, IV/2b and V/3a. The specificity of the method was verified by a panel of 177 HCV isolates of various genotypes in the genetic groups 1-9. It allowed clear differentiation of genotype I/1a from II/1b which was not always accomplished by the previous method. When 501 sera from blood donors and hepatitis patients with HCV viremia from various countries were genotyped by the second-generation method, 478 (95.4%) were classified into the five genotypes. HCV RNA samples from 23 (4.6%) sera were not classifiable into any of the five common genotypes and, by sequence analysis, 22 were found to be of four genotypes in group 4 and one of genotype 1c in Simmond's classification.