Clinical outcomes in patients with autoimmune hepatitis and primary biliary cholangitis overlap syndrome in the United States

IF 2.6 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology Pub Date : 2025-04-26 DOI:10.1016/j.clinre.2025.102598

Ritik M. Goyal , Bhavik Bansal , Mohammed Ayyad , Aagamjit Singh , Esli Medina Morales , Imran Qureshi , Muhammad Hassaan Arif Maan , Paul J. Gaglio

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引用次数: 0

Abstract

Background

There is evidence of overlap between autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC), two autoimmune hepatobiliary diseases. This retrospective analysis aimed to investigate extra-hepatic auto-immune diseases and compare outcomes of hospitalized patients with AIH-PBC overlap with AIH and PBC. We hypothesize that there are differences in rates of major adverse liver outcomes (MALO’s) when comparing these groups.

Methods

We conducted a retrospective cohort study using National Inpatient Sample 2016–2020. Patients with AIH, PBC and AIH-PBC were identified using respective ICD-10 codes. We performed weighted logistic and linear regression for predicting complications of cirrhosis, hospitalization outcomes, among AIH-PBC overlap cases when compared separately to AIH and PBC only populations as controls.

Results

A total of 2454 AIH, 1464 PBC, and 276 AIH-PBC overlap patients were identified, corresponding to weighted totals of 12,270, 7320 and 1380 patients, respectively. On multivariate analysis, we found that patients with AIH-PBC are more likely to have ascites (OR 3.03; p < 0.001) and portal hypertension (OR 3.75; p < 0.001) compared to AIH; whereas no significant difference was found out compared to PBC. There was no difference in the mortality and liver transplant needs in AIH-PBC overlap group. Overall higher rheumatological disease was present in the AIH-PBC overlap patients compared to AIH (26.45 % vs 8.96 %, p =< 0.001) and PBC (26.45 % vs 9.08 %, p =< 0.001). Specifically, AIH-PBC patients had higher prevalence of Sjogren’s syndrome (p < 0.001), SLE (p < 0.001), and systemic sclerosis (p < 0.001).

Conclusion

AIH-PBC Overlap syndrome is associated with increased rates of certain cirrhotic complications when compared to patients with AIH only. They do not differ in terms of clinical outcomes such as mortality when adjusted for demographics and comorbidities. Patients with AIH-PBC had a higher prevalence of rheumatological disorders; especially Sjogren’s, SLE, and systemic sclerosis.

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美国自身免疫性肝炎和原发性胆管炎重叠综合征患者的临床结果

有证据表明，自身免疫性肝炎（AIH）和原发性胆管炎（PBC）这两种自身免疫性肝胆疾病之间存在重叠。本回顾性分析旨在调查肝外自身免疫性疾病，并比较AIH-PBC与AIH和PBC重叠住院患者的预后。我们假设，当比较这些组时，主要不良肝脏结局（MALO’s）的发生率存在差异。方法采用2016-2020年全国住院患者样本进行回顾性队列研究。使用各自的ICD-10代码对AIH、PBC和AIH-PBC患者进行鉴定。我们对AIH-PBC重叠病例进行加权logistic和线性回归，以预测肝硬化并发症和住院结果，并将AIH和PBC重叠病例分别与仅AIH和PBC的人群作为对照进行比较。结果共发现AIH 2454例，PBC 1464例，AIH-PBC重叠276例，加权总数分别为12270例、7320例和1380例。在多变量分析中，我们发现AIH-PBC患者更容易发生腹水(OR 3.03；p & lt;0.001)和门静脉高压症(OR 3.75；p & lt;0.001)，与AIH相比；而与PBC相比无显著差异。AIH-PBC重叠组的死亡率和肝移植需求无差异。总体而言，AIH- pbc重叠患者的风湿病发病率高于AIH患者(26.45% vs 8.96%, p =<；0.001)和PBC (26.45% vs 9.08%, p =<；0.001)。具体而言，AIH-PBC患者有较高的干燥综合征患病率(p <；0.001), SLE (p <；0.001)，系统性硬化症(p <；0.001)。结论：与单纯AIH患者相比，AIH- pbc重叠综合征与某些肝硬化并发症发生率增加有关。根据人口统计学和合并症进行调整后，它们在临床结果（如死亡率）方面没有差异。AIH-PBC患者有较高的风湿病患病率；尤其是干燥症、SLE和系统性硬化症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics and research in hepatology and gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

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.