Systematic review and meta‐analysis on the incidence and prevalence of autoimmune hepatitis in Asian, European, and American population

Abstract

Background and Aim Reported incidence and prevalence rates of autoimmune hepatitis (AIH) have been sparse and heterogeneous. The aim of this meta‐analysis was to estimate the worldwide incidence and prevalence rates of AIH and reveal population difference. Methods Published articles on the epidemiology of AIH in PubMed, Embase, and Cochrane Library were systematically searched from inception to April 28, 2019. Two investigators independently reviewed these literatures and evaluated their quality. A random‐effects model was used to pool the overall incidence and prevalence rates. The impact of population difference, gender, age, study period, study quality, diagnostic criteria, and study design was further analyzed with subgroup analysis and meta‐regression. Results A total of 22 studies were included in the meta‐analysis. The pooled worldwide annual incidence and prevalence of AIH were 1.37 (95% confidence interval [CI]: 0.95–1.80) and 17.44 (95% CI: 12.01–22.87) per 100 000 persons, respectively. Subgroup analysis showed that the pooled annual incidence for Asian, European, and American population was 1.31 (95% CI: 0.42–2.20), 1.37 (95% CI: 1.10–1.64), and 1.00 (95% CI: 0.44–1.56) per 100 000 persons, respectively; the pooled prevalence for Asian, European, and American population was 12.99 (95% CI: 2.05–23.92), 19.44 (95% CI: 15.63–23.24), and 22.80 (95% CI: −13.48 to 59.07) per 100 000 persons, respectively. In addition, higher incidence and prevalence rates were observed in women than men, and a higher prevalence rate was observed in elderly than young people. Conclusions Autoimmune hepatitis is a rare disease, with a similar incidence worldwide and a higher prevalence in European and American than in Asian population.

Prevalence, clinical course, and predictive factors of immune checkpoint inhibitor monotherapy‐associated hepatitis in Japan

“…demonstrated that in melanoma patients who were treated with ipilimumab, female sex was significantly associated with a higher risk of severe irAE 9 . Female sex is a risk factor for several autoimmune diseases, including autoimmune hepatitis; 23 thus, sex could influence the incidence of irAE hepatitis. In addition, as in previous reports, 24,25 our study showed that male sex is significantly associated with a high objective response rate (data not shown).…”

Characteristics and Long-term Outcome of 535 Patients with Histologically Confirmed Autoimmune Hepatitis (AIH) - A Single Center Experience of 18 Years

“…Genetic and environmental factors seem to play a crucial role. Despite being a rare liver disease with an estimated prevalence of 2-17 cases per 100'000 in Europe, we observe a notably increase in disease incidence within the last years [2]. In some cases, patients present an overlap to other hepato-biliary diseases such as primary biliary cholangitis (PBC) or primary sclerosing cholangitis (PSC).…”

The Asian Pacific Association for the Study of the Liver clinical practice guidance: the diagnosis and management of patients with autoimmune hepatitis

“…However, this disease presents with a strong female predominance and geographic variation [ 1 ]. As summarized in a recent meta-analysis, the AIH has a global annual incidence of 1.37 per 100,000 (1.11 for female and 0.22 for male) and prevalence 17.44 per 100,000 (12.77 for female and 2.91 for male) [ 2 ]. The pooled annual incidence rate in Asian (1.31/100,000) is similar to that in European (1.37/100,000) and American population (1.00/100,000); however, the pooled prevalence rate in Asian (12.99/100,000) is lower than that in European (19.44/100,000) and American population (22.80/100,000) [ 2 ].…”

“…As summarized in a recent meta-analysis, the AIH has a global annual incidence of 1.37 per 100,000 (1.11 for female and 0.22 for male) and prevalence 17.44 per 100,000 (12.77 for female and 2.91 for male) [ 2 ]. The pooled annual incidence rate in Asian (1.31/100,000) is similar to that in European (1.37/100,000) and American population (1.00/100,000); however, the pooled prevalence rate in Asian (12.99/100,000) is lower than that in European (19.44/100,000) and American population (22.80/100,000) [ 2 ]. One possible explanation for this incidence–prevalence discrepancy would be the late onset or diagnosis and shorter survival of the AIH in Asian population [ 3 , 4 ].…”