Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 20;7(8):545-552.
doi: 10.1002/jgh3.12946. eCollection 2023 Aug.

Autoimmune hepatitis and overlap syndrome among Alaska Native people: Prevalence, clinical characteristics, and remission

Janet M Johnston  1 , Brian McMahon  1 , Lisa Townshend-Bulson  1 , Julia Plotnik  1 , Paarth Jain  1 , Meggan Judge  1 , Wileina Rhodes  1 , Chriss Homan  1
Affiliations

Autoimmune hepatitis and overlap syndrome among Alaska Native people: Prevalence, clinical characteristics, and remission

Janet M Johnston et al. JGH Open. .

Abstract

Background and aim: High autoimmune hepatitis (AIH) and overlap syndrome (OS) prevalence have been previously documented among Alaska Native people. The purpose of this project is to report changes in AIH/OS prevalence over time, clinical characteristics, and factors associated with biochemical remission.

Methods: We reviewed medical records for Alaska Native/American Indian (AN/AI) patients diagnosed with AIH/OS between 1984 and 2021. Point prevalence was calculated based on AIH/OS patients alive at the end of 2021 and at 5-year intervals from July 1, 2000, to July 1, 2020.

Results: We identified 189 AN/AI persons diagnosed with AIH or OS (157 AIH, 32 OS). Of these 189, 137 were alive at the end of 2021 for a point prevalence of 91.2 per 100 000 (95% confidence interval [CI]: 77.2-107.8)-75.9 (95% CI: 63.2-91.2) for AIH and 15.3 (95% CI: 10.2-23.0) for OS. Prevalence for both AIH and OS has risen steadily since 2000. Eighty-nine consented participants (62.7%) achieved biochemical remission with a median time from diagnosis to start of remission of 1.9 years (IQR 0.5-5.0 years). Consented patients with fatty liver were less likely to achieve remission, but their time to remission was shorter than for patients without fatty liver.

Conclusion: The AN/AI population in Alaska continues to have the highest reported prevalence of AIH/OS in the world, with prevalence rising steadily since 2000. High reported AIH/OS prevalence is likely due in part to strong referral networks for liver disease. Detection and treatment can lead to biochemical remission and improved health outcomes.

Keywords: Alaska Native; autoimmune hepatitis; overlap syndrome; prevalence; remission.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Autoimmune hepatitis and overlap syndrome prevalence, 2000–2020. formula image, autoimmune hepatitis (AIH) and overlap syndrome (OS); formula image, AIH only; formula image, OS.
Figure 2
Figure 2
Age at diagnosis (years).
Figure 3
Figure 3
(a) Percentage of consented patients with F3/F4 Metavir fibrosis score at time of diagnosis and F0/F1/F2 at most recent FibroScan. formula image, all; formula image, controlled; formula image not controlled. (b) Percentage of consented patients with F0/F1/F2 Metavir fibrosis score at time of diagnosis and F3/F4 at most recent FibroScan. formula image, all; formula image, controlled; formula image not controlled.
Figure 4
Figure 4
Autoimmune hepatitis prevalence (per 100 000): Population‐based estimates from 1995 to 2021.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. van Gerven NM, de Boer YS, Mulder CJ, van Nieuwkerk CM, Bouma G. Auto immune hepatitis. World J. Gastroenterol. 2016; 22: 4651–4661. - PMC - PubMed
    1. Rust C, Beuers U. Overlap syndromes among autoimmune liver diseases. World J. Gastroenterol. 2008; 14: 3368–3373. - PMC - PubMed
    1. Hurlburt KJ, McMahon BJ, Deubner H, Hsu‐Trawinski B, Williams JL, Kowdley KV. Prevalence of autoimmune liver disease in Alaska Natives. Am. J. Gastroenterol. 2002; 97: 2402–2407. - PubMed
    1. Ngu JH, Bechly K, Chapman BA et al. Population‐based epidemiology study of autoimmune hepatitis: a disease of older women? J. Gastroenterol. Hepatol. 2010; 25: 1681–1686. - PubMed
    1. Lee YM, Teo EK, Ng TM, Khor C, Fock KM. Autoimmune hepatitis in Singapore: a rare syndrome affecting middle‐aged women. J. Gastroenterol. Hepatol. 2001; 16: 1384–1389. - PubMed