RESUMO
Twenty eight Yemeni patients with nonviral chronic active liver disease were retrospectively studied for underlying causes and possible predisposing risk factors. They were 17 males and 11 females with age range between 17 and 42 years [median 29.5 years]. The diagnosis was based on their clinical, biochemical and imaging criteria, and was consistent with severe chronic liver disease that was persistent for more than six months. Seroimmunological markers for autoimmune liver disease were found in 8 patients [4 males and 4 females]. Slit-lamp examination for Kaiser-Fleicher ring, which is characteristic for Wilson's disease, was negative in all patients and serum iron and serum ferritin were normal in two patients over 40 years. Habitual qat chewing was found in 27 patients, of which 20 were daily qat chewers. Meanwhile, good response to immune suppressive treatment was documented in 22 patients. These results indicate that most Yemeni patients with nonviral chronic active liver disease are young, heavy qat chewers and have good response to immune suppressive treatment. These findings may suggest an underlying immunologic pathogenic mechanism for the chronic active liver disease in these patients. Further studies are needed to investigate the nonviral causes of chronic liver disease and the possible implication of qat chewing habit in liver diseases as well as in other diseases in Yemeni population