Advancements in autoimmune hepatitis epidemiology, treatment and complication – a 15-year retrospective study

IF 2.6 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Mifleh Tatour , Fadi Abu Baker , Tarek Saadi , Ahmad Yahia , Rawi Hazzan
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引用次数: 0

Abstract

Introduction and Objectives

Autoimmune hepatitis (AIH) is a rare, heterogeneous liver disease marked by autoantibodies, hypergammaglobulinemia, and distinct histological features. Predominantly affecting women, its incidence and prevalence show significant regional variability globally. Therefore, our aim is to examine the trends of AIH and to assess its demographics, management, and disease progression using an extensive population-based database.

Materials and Methods

This retrospective, population-based study analyzed data from 2.7 million adults in Clalit Health Services, focusing on autoimmune hepatitis (AIH) diagnoses between 2009 and 2023. Data reordered included demographics, clinical details, and treatment regimens. Key outcomes tracked were the development of cirrhosis and its complications.

Results

This study included 992 AIH patients with a median age of 51.5 years, 80.4 % female, and a median follow-up of 6.1 years. Obesity was present in 23.2 %, and 10.9 % had thyroid disease. At diagnosis, 22.9 % had cirrhosis, and an additional 137 patients developed cirrhosis during follow-up, leading to a total prevalence of 36.5 %. Among cirrhotic patients, 29.9 % experienced decompensation, 25.3 % developed ascites, 9.3 % had variceal bleeding, and 10.4 % developed hepatic encephalopathy. Hepatocellular carcinoma (HCC) occurred in 5.24 % of cirrhotic patients, with an incidence rate of 6.32 cases per 1000 patient-years. Overall, 11.2 % of cirrhotic patients underwent liver transplantation. The proportion of AIH patients diagnosed with cirrhosis at the time of diagnosis significantly decreased over the study period (p = 0.0028).

Conclusions

This study demonstrates a decreasing trend in AIH patients diagnosed with cirrhosis, suggesting earlier detection and improved management, alongside a lower documented incidence of HCC.
自身免疫性肝炎流行病学、治疗和并发症的进展-一项15年回顾性研究。
简介和目的:自身免疫性肝炎(AIH)是一种罕见的异质肝病,以自身抗体、高γ球蛋白血症和独特的组织学特征为特征。主要影响妇女,其发病率和流行率在全球范围内表现出显著的区域差异。因此,我们的目的是研究AIH的趋势,并利用广泛的基于人群的数据库评估其人口统计学、管理和疾病进展。材料和方法:这项基于人群的回顾性研究分析了Clalit健康服务中心270万成年人的数据,重点关注2009年至2023年间自身免疫性肝炎(AIH)的诊断。重新排序的数据包括人口统计、临床细节和治疗方案。跟踪的主要结果是肝硬化及其并发症的发展。结果:本研究纳入992例AIH患者,中位年龄51.5岁,女性80.4%,中位随访6.1年。23.2%的人肥胖,10.9%的人患有甲状腺疾病。在诊断时,22.9%患有肝硬化,另外137例患者在随访期间出现肝硬化,导致总患病率为36.5%。在肝硬化患者中,29.9%发生代偿失代偿,25.3%发生腹水,9.3%发生静脉曲张出血,10.4%发生肝性脑病。肝硬化患者中发生肝细胞癌(HCC)的比例为5.24%,发病率为每1000患者年6.32例。总体而言,11.2%的肝硬化患者接受了肝移植。诊断时诊断为肝硬化的AIH患者比例在研究期间显著下降(p = 0.0028)。结论:该研究表明,诊断为肝硬化的AIH患者呈下降趋势,提示早期发现和改善治疗,同时HCC的发生率较低。
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来源期刊
CiteScore
4.30
自引率
3.70%
发文量
198
审稿时长
42 days
期刊介绍: Clinics and Research in Hepatology and Gastroenterology publishes high-quality original research papers in the field of hepatology and gastroenterology. The editors put the accent on rapid communication of new research and clinical developments and so called "hot topic" issues. Following a clear Editorial line, besides original articles and case reports, each issue features editorials, commentaries and reviews. The journal encourages research and discussion between all those involved in the specialty on an international level. All articles are peer reviewed by international experts, the articles in press are online and indexed in the international databases (Current Contents, Pubmed, Scopus, Science Direct). Clinics and Research in Hepatology and Gastroenterology is a subscription journal (with optional open access), which allows you to publish your research without any cost to you (unless you proactively chose the open access option). Your article will be available to all researchers around the globe whose institution has a subscription to the journal.
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