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The incidence and prevalence of autoimmune hepatitis (AIH) continues to increase, suggesting it may become a major global health problem, according to a new meta-analysis.Published last month in eClinical Medicine,This systematic review and meta-analysis was conducted to identify global, regional and national trends in AIH from 1970 to 2022.
The study was funded by the National Research Foundation of Korea. The corresponding author is Dong Keon Yon, MD, Department of Pediatrics, Kyung Hee University School of Medicine, and colleagues from Greece, Iran, South Korea, Spain, Sweden, and the United Kingdom. The United States analyzed 37 studies involving people from 18 55,839 AIH patients in countries.
AIH is a rare but serious condition, a chronic liver disease characterized by liver inflammation caused by the body’s immune system mistakenly attacking healthy liver cells. Although this immune-mediated disease is hypothesized to result from loss of immune tolerance in genetically susceptible individuals, it affects all persons of all ages, genders, and races.
Patients may have a range of symptoms, from no symptoms to chronic disease or acute liver failure. According to the AASLD practice guideline for AIH, AIH should be considered a possible diagnosis in all patients with liver inflammation, including those who have undergone liver transplantation and develop graft dysfunction. AIH does not have one specific diagnostic feature, so doctors look for a combination of typical features that can vary from patient to patient and reflect other liver diseases. If left untreated, AIH may lead to advanced liver fibrosis, cirrhosis, liver failure, or the need for liver transplantation. Immunosuppressive drug therapy has been the first-line treatment and has been successful in saving lives, but these treatment regimens can be long-term, can have serious side effects, and have inconsistent results among different patients.
Yon and colleagues collected data from a variety of sources, including medical databases, research articles, and national health statistics. After a thorough screening process, a total of 37 comparative studies, representing a wide range of countries and populations, were included in the meta-analysis. Data from these studies were then pooled and analyzed to estimate the global incidence and prevalence of autoimmune hepatitis.
Research results show that the global incidence of AIH has increased steadily over the past 50 years, reaching 1.28 cases per 100,000 person-years and 15.65 cases per 100,000 residents.
Similarly, meta-analyses also found an increasing trend in the prevalence of AIH. In 1970, the estimated prevalence was 9.95 cases per 100,000 people, while in 2022 it was 27.91 cases per 100,000 people.
Yon and colleagues also found regional differences in the incidence and prevalence of AIH. Compared with other regions, Western countries, especially North America and European countries, have a higher incidence of AIH. This may be attributed to a variety of factors, such as differences in genetic predisposition, environmental triggers, and access to health care.
The researchers also studied the sex distribution of AIH. Like other autoimmune diseases, AIH appears to disproportionately affect women.