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. 2021 Nov-Dec;55(10):903-910.
doi: 10.1097/MCG.0000000000001449.

Epidemiology of Autoimmune Hepatitis (AIH) in the United States Between 2014 and 2019: A Population-based National Study

Nahel A Tunio  1 , Emad Mansoor  2 , Mohammed Z Sheriff  1 , Gregory S Cooper  2 , Seth N Sclair  2 , Stanley M Cohen  2
Affiliations

Epidemiology of Autoimmune Hepatitis (AIH) in the United States Between 2014 and 2019: A Population-based National Study

Nahel A Tunio et al. J Clin Gastroenterol. 2021 Nov-Dec.

Abstract

Background and aims: Autoimmune hepatitis (AIH) is a chronic, inflammatory disease of the liver with increasing prevalence. However, limited epidemiological data exist for the prevalence of AIH in the United States. We used a large database to describe the prevalence of AIH in the United States and the autoimmune diseases associated with it.

Approach and results: Data was collected from a commercial database (Explorys Inc., Cleveland, OH), an aggregate of Electronic Health Record data from 26 major integrated health care systems in the United States. We identified a cohort of patients with a diagnosis of AIH from April 2014 to April 2019 based on a Systemized Nomenclature of Medicine-Clinical Terms and calculated the prevalence of AIH. Of the 37,161,280 individuals active in the database from April 2014 to 2019, we identified 11,600 individuals with a diagnosis of AIH with an overall prevalence rate of 31.2/100,000. The prevalence of AIH was increased in females compared with males [odds ratio (OR)=3.21, P<0.0001], elderly (aged above 65 y) compared with adults (aged 18 to 65 y) and children (aged below 18 y) (OR=2.51, P<0.0001) and whites compared with African Americans, Asians, and Hispanics (OR=1.12, P<0.0001). Moreover, patients with AIH were more likely to have Sjögren syndrome, systemic lupus erythematosus, ulcerative colitis, celiac disease, rheumatoid arthritis, Crohn's disease, and autoimmune thyroiditis as compared with patients without AIH.

Conclusions: We found that the estimated prevalence of AIH in the United States is 31.2/100,000, which is comparable to the reported prevalence of AIH in Europe. We confirmed that AIH has a strong association with other autoimmune diseases studied in the literature.

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Conflict of interest statement

Conflicts of interest: There are no potential conflicts (financial, professional, or personal) to disclose by all the authors (Nahel A. Tunio MD, Emad Mansoor MD, Mohammed Z. Sheriff, Gregory S. Cooper MD, Seth N. Sclair MD, Stanley M. Cohen MD).

Figures

Figure 1:
Figure 1:
Prevalence (per 100,000) of Autoimmune Hepatitis in the United States between 2014 and 2019 overall and among different age-based, race-based and gender-based groups
Figure 2:
Figure 2:
5-year Age Interval Based Prevalence (per 100,000) of AIH in the United States between 2014 and 2019
Figure 3:
Figure 3:
GI symptoms and findings in female and male patients with AIH. Odd ratios for findings in female patients as compared to male patients indicated on the top of the bars
Figure 4:
Figure 4:
Percentage of patients with AIH and other autoimmune diseases
See this image and copyright information in PMC

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