Khat chewing increases the risk for developing chronic liver disease: A hospital‐based case–control study

Abstract

A significant association was observed between chewing khat and the risk for developing CLD, and in men the association was strong and dose-dependent, suggesting a causal relationship; as the prevalence of khat chewing is increasing worldwide, these findings have major public health implications. (Hepatology 2018;68:248-257).

High Seroprevalence of Autoantibodies Typical of Autoimmune Liver Disease in Eastern Ethiopia: Is Chewing of Khat (Catha edulis) a Triggering Factor?

“…A case-control study was undertaken at Hiwot Fana Specialized University Hospital and Jugal Hospital in Harar, Ethiopia, between April 2015 and April 2016, as previously described [12]. Study subjects for the present analysis were the controls from the previous study, and comprised of adults aged 18 years and above attending the ophthalmology, dermatology, or surgical services during the study period.…”

“…In lack of validated criteria for the quantification of khat usage, we established a screening tool to assess khat consumption as described in previous publications [12, 19]. By combining information on khat usage quantified in grams using a visual analogue scale (Figure 1) with the frequency and duration of khat usage categorized using the Drug Use Disorders Identification Test [20], we classified lifetime khat exposure as khat-years .…”

“…In an earlier case-control study, we demonstrated a strong and significant association between khat chewing and chronic liver disease in Ethiopia [12]; however, the mechanism of liver injury was not addressed. A few previous case reports have described khat-related liver injury mimicking autoimmune hepatitis, and the authors speculate that khat might trigger an autoimmune reaction in susceptible individuals [13–15].…”

“…In the present study, which was nested in a previously published case-control study [12], we aimed to assess (i) the seroprevalence of autoantibodies typical of autoimmune liver diseases in a well-defined study population in Ethiopia and (ii) to explore the hypothesis that khat usage triggers autoimmunity. Results from this study might pave the road for a better understanding and ultimately better treatment of khat-related liver injury.…”

Serum Positivity of Ana and Asma Among Khat and Nonkhat Chewers as Markers for Autoimmune Hepatitis Type 1

“…The khat leaves chewed daily by a high proportion of the adult population in Yemen for the pleasant mild stimulant effect 18 . Khat has recently been recognized as a triggering agent for a severe form of AIH in young males in Yemen and Somalia [19][20][21][22][23] . Current study aimed to measure serum ANA and ASMA as early markers for AIH type1 in Yemeni healthy people who chew khat.…”