Incidence, prevalence and mortality of autoimmune hepatitis in England 1997‐2015. A population‐based cohort study

Grønbæk, Lisbet; Otete, Harmony; Ban, Lu; Crooks, Colin J; Card, Timothy R.; Jepsen, Peter; West, Joe

doi:10.1111/liv.14480

Cited by 47 publications

(47 citation statements)

References 57 publications

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“…CLD diagnoses were made based on documentation of at least 1 OMOP concept identifier corresponding to previously validated ICD-10-CM codes for liver diseases (Supplementary Table 2) at any time before the index date. [19][20][21][22] As "steatosis of the liver" is a common finding in alcohol-associated liver disease (AALD) and nonalcoholic fatty liver disease (NAFLD), patients with OMOP concept identifier 4059290 (corresponding to ICD-10-CM code K76.0) and at least 1 OMOP concept identifier describing alcohol use (Supplementary Table 2) in accordance with definitions by the Centers for Disease Control and Prevention and the National Institute on Alcohol Abuse and Alcoholism Alcohol Epidemiologic Data System, were categorized as those with AALD. [23][24][25][26] Patients with OMOP concept identifier 4059290 without an alcohol use OMOP concept identifier were categorized as NAFLD.…”

Section: Definitions Of Chronic Liver Disease and Cirrhosismentioning

confidence: 99%

Outcomes of SARS-CoV-2 Infection in Patients With Chronic Liver Disease and Cirrhosis: A National COVID Cohort Collaborative Study

et al. 2021

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Background and Aims In chronic liver disease (CLD) patients with or without cirrhosis, existing studies on the outcomes with SARS-CoV-2 infection have limited generalizability. We used the National COVID Cohort Collaborative (N3C), a harmonized electronic health record (EHR) dataset of 6.4 million, to describe SARS-CoV-2 outcomes in patients with CLD and cirrhosis. Methods We identified all CLD patients with or without cirrhosis who had SARS-CoV-2 testing in the N3C Data Enclave as of 7/1/2021. We used survival analyses to associate SARS-CoV-2 infection, presence of cirrhosis, and clinical factors with the primary outcome of 30-day mortality. Results We isolated 220,727 patients with CLD and SARS-CoV-2 test status: 128,864 (58%) Non-Cirrhosis/Negative, 29,446 (13%) Non-Cirrhosis/Positive, 53,476 (24%) Cirrhosis/Negative, and 8,941 (4%) Cirrhosis/Positive patients. Thirty-day all-cause mortality rates were 3.9% in Cirrhosis/Negative and 8.9% in Cirrhosis/Positive patients. Compared to Cirrhosis/Negative, Cirrhosis/Positive had 2.38-times adjusted hazard of death at 30 days. Compared to Non-Cirrhosis/Positive, Cirrhosis/Positive had 3.31-times adjusted hazard of death at 30 days. In stratified analyses among patients with cirrhosis with increased age, obesity, and comorbid conditions (diabetes, heart failure, and pulmonary disease); SARS-CoV-2 infection was associated with increased adjusted hazards of death. Conclusions In this study of ∼221,000 nationally-representative, diverse, and gender-balanced CLD patients; we found SARS-CoV-2 infection in patients with cirrhosis was associated with 2.38-times mortality hazard, and the presence of cirrhosis among CLD patients infected with SARS-CoV-2 was associated with 3.31-times mortality hazard. These results provide an additional impetus for increasing vaccination uptake and further research regarding immune responses to vaccines in patients with severe liver disease.

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Section: Definitions Of Chronic Liver Disease and Cirrhosismentioning

confidence: 99%

Outcomes of SARS-CoV-2 Infection in Patients With Chronic Liver Disease and Cirrhosis: A National COVID Cohort Collaborative Study

et al. 2021

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“…Autoimmune hepatitis (AIH) is a liver-specific autoimmune disease first described in 1951 (5). AIH manifests in all age groups, and its incidence has shown an increasing trend (20). The disease is now widely known as a consequence of immune tolerance breakdown, leading to an autoimmune response against hepatocytes that induces liver injury (21).…”

Section: Aih: Current Research Statusmentioning

confidence: 99%

Regulatory T Cells in Autoimmune Hepatitis: Unveiling Their Roles in Mouse Models and Patients

et al. 2020

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Autoimmune hepatitis (AIH) is a severe and chronic liver disease, and its incidence has increased worldwide in recent years. Research into the pathogenesis of AIH remains limited largely owing to the lack of suitable mouse models. The concanavalin A (ConA) mouse model is a typical and well-established model used to investigate T cell-dependent liver injury. However, ConA-induced hepatitis is acute and usually disappears after 48 h; thus, it does not mimic the pathogenesis of AIH in the human body. Several studies have explored various AIH mouse models, but as yet there is no widely accepted and valid mouse model for AIH. Immunosuppression is the standard clinical therapy for AIH, but patient side effects and recurrence limit its use. Regulatory T cells (Tregs) play critical roles in the maintenance of immune homeostasis and in the prevention of autoimmune diseases, which may provide a potential therapeutic target for AIH therapy. However, the role of Tregs in AIH has not yet been clarified, partly because of difficulties in diagnosing AIH and in collecting patient samples. In this review, we discuss the studies related to Treg in various AIH mouse models and patients with AIH and provide some novel insights for this research area.

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“…Early epidemiological studies, carried out before the publication of diagnostic criteria, report an incidence ranging from 0.1 to 1.9 cases/100,000 in European countries and Japan [ 1 ]. More recent studies from Europe report higher disease frequency, with an incidence ranging from 1.1 to 2.56 and a prevalence ranging from 17.3 to 18.3/100,000 inhabitants [ 11 – 14 ]. Studies in more recent years report an even higher incidence [ 11 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…More recent studies from Europe report higher disease frequency, with an incidence ranging from 1.1 to 2.56 and a prevalence ranging from 17.3 to 18.3/100,000 inhabitants [ 11 – 14 ]. Studies in more recent years report an even higher incidence [ 11 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Autoimmmune hepatitis

2021

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Autoimmune hepatitis (AIH) is a T-cell mediated, inflammatory liver disease affecting all ages and characterized by female preponderance, elevated serum transaminase and immunoglobulin G levels, positive circulating autoantibodies, and presence of interface hepatitis at liver histology. AIH type 1, affecting both adults and children, is defined by positive anti-nuclear and/or anti-smooth muscle antibodies, while type 2 AIH, affecting mostly children, is defined by positive anti-liver-kidney microsomal type 1 and/or anti-liver cytosol type 1 antibody. While the autoantigens of type 2 AIH are well defined, being the cytochrome P4502D6 (CYP2D6) and the formiminotransferase cyclodeaminase (FTCD), in type 1 AIH they remain to be identified. AIH-1 predisposition is conferred by possession of the MHC class II HLA DRB1*03 at all ages, while DRB1*04 predisposes to late onset disease; AIH-2 is associated with possession of DRB1*07 and DRB1*03. The majority of patients responds well to standard immunosuppressive treatment, based on steroid and azathioprine; second- and third-line drugs should be considered in case of intolerance or insufficient response. This review offers a comprehensive overview of pathophysiological and clinical aspects of AIH.

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Incidence, prevalence and mortality of autoimmune hepatitis in England 1997‐2015. A population‐based cohort study

Abstract: Lisbet Grønbaek received funding from the Danish foundation of 17.12.1981 and the Danish Foundation of A.P. Møller. The funding sources were not involved in the conduct of the research or preparation of the article.

Cited by 47 publications

References 57 publications

Outcomes of SARS-CoV-2 Infection in Patients With Chronic Liver Disease and Cirrhosis: A National COVID Cohort Collaborative Study

Outcomes of SARS-CoV-2 Infection in Patients With Chronic Liver Disease and Cirrhosis: A National COVID Cohort Collaborative Study

Regulatory T Cells in Autoimmune Hepatitis: Unveiling Their Roles in Mouse Models and Patients

Autoimmmune hepatitis

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