Enomoto Hirayuki, Nishiguchi Shuhei
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Inflamm Intest Dis. 2017 Apr;1(4):150-158. doi: 10.1159/000454879. Epub 2017 Feb 3.
Autoimmune hepatitis (AIH) is a relatively rare disease that can develop regardless of age or ethnicity. However, its clinical features differ between eastern and western populations due to several heterogeneous genetic and environmental factors. We herein report the clinical characteristics of AIH patients in East Asia, Southeast Asia, and South Asia.
The prevalence of AIH in eastern countries is considered to be lower than in western countries. Although a few young patients with type 2 AIH have been observed in South Asia, most patients in Asia are middle-aged women with type 1 AIH who respond well to steroid-based immunosuppressive therapy. Human leukocyte antigen DR4 is suggested to be an influential factor in the genetic background of AIH patients in Asia, particularly in East Asia. Notably, AIH may be induced by some societal- or culture-associated medicines, including herbal medicines. The IAIHG (International Autoimmune Hepatitis Group) scoring systems are generally accepted as the standard diagnostic methods for AIH in Asian countries. The results of repeated nationwide surveys in Japan suggest that the clinical features of AIH patients in East Asia are changing, with IgG levels and rates of anti-nuclear antibody positivity decreasing.
自身免疫性肝炎（AIH）是一种相对罕见的疾病，可在任何年龄或种族中发生。然而，由于多种异质性遗传和环境因素，其临床特征在东西方人群中存在差异。我们在此报告东亚、东南亚和南亚AIH患者的临床特征。
东方国家AIH的患病率被认为低于西方国家。虽然在南亚观察到少数2型AIH的年轻患者，但亚洲的大多数患者是1型AIH的中年女性，她们对基于类固醇的免疫抑制治疗反应良好。人类白细胞抗原DR4被认为是亚洲AIH患者遗传背景中的一个影响因素，尤其是在东亚。值得注意的是，AIH可能由一些与社会或文化相关的药物诱发，包括草药。国际自身免疫性肝炎小组（IAIHG）评分系统在亚洲国家通常被视为AIH的标准诊断方法。日本全国范围内反复调查的结果表明，东亚AIH患者的临床特征正在发生变化，IgG水平和抗核抗体阳性率在下降。
