Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
Liver Int. 2022 Aug;42(9):2015-2022. doi: 10.1111/liv.15155. Epub 2022 Jan 10.
Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease that mainly injures the hepatocytes. The autoimmune disease might be involved in its aetiology, but this remains to be confirmed. Recently epidemiological studies of AIH in Asia have been broadly conducted, revealing characteristics and management of AIH patients in Asia. In East Asia, most AIH patients are type 1, and type 2 AIH is very rare. However, type 2 AIH in South Asia is as frequent as in Europe and the USA. HLA-DR4 is associated with the characteristics of type 1 AIH in East Asia, whereas HLA-DR3 occurs in AIH patients from South Asia. AIH prevalence worldwide is increasing, and several studies have reported a prevalence of 19.44, 22.80 and 12.99 per 100 000 people in Europe, the USA and Asia respectively. A meta-analysis of studies on AIH showed similar annual incidence rates for all regions, with 1.31, 1.37 and 1.00 per 100 000 people in Asia, Europe and the USA respectively. The increase in the rates could be attributable to the increased awareness of disease concepts and diagnosis. In South Asia, most cases were diagnosed as AIH only after having progressed to cirrhosis, which may cause a higher mortality rate in South Asia than in East Asia. Therefore, the early diagnosis and treatment of AIH patients can improve the current situation in Asia.
自身免疫性肝炎（AIH）是一种主要损伤肝细胞的慢性炎症性肝病。自身免疫性疾病可能与其发病机制有关，但这仍有待证实。最近亚洲对 AIH 的流行病学研究广泛开展，揭示了亚洲 AIH 患者的特点和管理方法。在东亚，大多数 AIH 患者为 1 型，2 型 AIH 非常罕见。然而，南亚的 2 型 AIH 与欧洲和美国一样常见。HLA-DR4 与东亚 1 型 AIH 的特征相关，而 HLA-DR3 则发生在南亚的 AIH 患者中。全球 AIH 的患病率正在增加，几项研究报告称，欧洲、美国和亚洲的患病率分别为每 10 万人 19.44、22.80 和 12.99。对 AIH 研究的荟萃分析显示，所有地区的年发病率相似，亚洲、欧洲和美国分别为每 10 万人 1.31、1.37 和 1.00。发病率的增加可能归因于对疾病概念和诊断的认识提高。在南亚，大多数病例只有发展到肝硬化后才被诊断为 AIH，这可能导致南亚的死亡率高于东亚。因此，早期诊断和治疗 AIH 患者可以改善亚洲的现状。
