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. 2023 Feb 1;77(2):367-378.
doi: 10.1002/hep.32653. Epub 2022 Jul 22.

Sociodemographic and geographic differences in the US epidemiology of autoimmune hepatitis with and without cirrhosis

Therese Bittermann  1   2 , James D Lewis  1   2 , Cynthia Levy  3 , David S Goldberg  3
Affiliations

Sociodemographic and geographic differences in the US epidemiology of autoimmune hepatitis with and without cirrhosis

Therese Bittermann et al. Hepatology. .

Erratum in

Abstract

Background and aims: Data on the epidemiology of autoimmune hepatitis (AIH) in the United States are limited. This study investigated the sociodemographic and geographic factors associated with AIH incidence and prevalence with and without cirrhosis.

Approach and results: In a retrospective cohort of adults in the Optum Clinformatics Data Mart (2009-2018), we identified AIH cases using a validated claims-based algorithm. Incidence and prevalence were compared between sociodemographic subgroups. Logistic regression evaluated the association of US Census Division with AIH incidence and the factors associated with incident AIH with cirrhosis. From 2009 to 2018, the age- and sex-standardized prevalence of AIH in the Optum cohort was 26.6 per 100,000 persons with an incidence of 4.0 per 100,000 person-years. AIH incidence increased earlier among Hispanics (age 50-59 years) and later among Asians (≥80 years). Adjusted AIH incidence was higher in the Mountain Division (odds ratio [OR] 1.17) and lower in the Pacific (OR 0.68), Middle Atlantic (OR 0.81), and West North Central Divisions (OR 0.86 vs. East North Central; p < 0.001). Male sex (OR 1.31, p = 0.003), Black race (OR 1.32, p = 0.022), and Hispanic ethnicity (OR 1.37 vs. non-Hispanic White, p = 0.009) were associated with incident AIH with cirrhosis. Incident AIH with cirrhosis was greater in the West South Central Division (OR 1.30 vs. South Atlantic; p = 0.008).

Conclusions: AIH epidemiology differs according to sociodemographic and geographic factors in the United States. Studies are needed to determine the genetic, epigenetic, and environmental factors underlying the heterogeneity in AIH risk and outcomes.

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Figures

Figure 1:
Figure 1:
AIH incidence between sociodemographic subgroups: (A) sex and race/ethnicity; (B) sex and age; (C) race/ethnicity and age
Figure 2:
Figure 2:
AIH prevalence (A) and incidence (B) between 2009-2018 by U.S. Census Division
Figure 3:
Figure 3:
AIH incidence by U.S. Census Division among White (A), Black (B), Hispanic (C) and Asian (D) patients
Figure 4:
Figure 4:
Adjusted probability of incident AIH with cirrhosis by U.S. Census Division
See this image and copyright information in PMC

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