Division of Gastroenterology & Hepatology , Perelman School of Medicine , University of Pennsylvania , Philadelphia , Pennsylvania , USA.
Department of Biostatistics and Epidemiology and Informatics , Perelman School of Medicine , University of Pennsylvania , Philadelphia , Pennsylvania , USA.
Hepatology. 2023 Feb 1;77(2):367-378. doi: 10.1002/hep.32653. Epub 2022 Jul 22.
Data on the epidemiology of autoimmune hepatitis (AIH) in the United States are limited. This study investigated the sociodemographic and geographic factors associated with AIH incidence and prevalence with and without cirrhosis.
In a retrospective cohort of adults in the Optum Clinformatics Data Mart (2009-2018), we identified AIH cases using a validated claims-based algorithm. Incidence and prevalence were compared between sociodemographic subgroups. Logistic regression evaluated the association of US Census Division with AIH incidence and the factors associated with incident AIH with cirrhosis. From 2009 to 2018, the age- and sex-standardized prevalence of AIH in the Optum cohort was 26.6 per 100,000 persons with an incidence of 4.0 per 100,000 person-years. AIH incidence increased earlier among Hispanics (age 50-59 years) and later among Asians (≥80 years). Adjusted AIH incidence was higher in the Mountain Division (odds ratio [OR] 1.17) and lower in the Pacific (OR 0.68), Middle Atlantic (OR 0.81), and West North Central Divisions (OR 0.86 vs. East North Central; p < 0.001). Male sex (OR 1.31, p = 0.003), Black race (OR 1.32, p = 0.022), and Hispanic ethnicity (OR 1.37 vs. non-Hispanic White, p = 0.009) were associated with incident AIH with cirrhosis. Incident AIH with cirrhosis was greater in the West South Central Division (OR 1.30 vs. South Atlantic; p = 0.008).
AIH epidemiology differs according to sociodemographic and geographic factors in the United States. Studies are needed to determine the genetic, epigenetic, and environmental factors underlying the heterogeneity in AIH risk and outcomes.
美国自身免疫性肝炎 (AIH) 的流行病学数据有限。本研究调查了与 AIH 发病率和患病率相关的社会人口学和地理因素，包括有无肝硬化。
在 Optum Clinformatics Data Mart（2009-2018 年）的一项回顾性成人队列研究中，我们使用经过验证的基于索赔的算法确定 AIH 病例。在社会人口统计学亚组之间比较发病率和患病率。Logistic 回归评估了美国人口普查区与 AIH 发病率的关系，以及与肝硬化相关的 AIH 发病因素。2009 年至 2018 年，Optum 队列中 AIH 的年龄和性别标准化患病率为每 10 万人 26.6 例，发病率为每 10 万人 4.0 例。西班牙裔（50-59 岁）人群的 AIH 发病较早，而亚洲人（≥80 岁）发病较晚。调整后的 AIH 发病率在山区（比值比 [OR] 1.17）较高，在太平洋（OR 0.68）、中大西洋（OR 0.81）和中西部（OR 0.86 与中北部；p <0.001）较低。男性（OR 1.31，p =0.003）、黑种人（OR 1.32，p =0.022）和西班牙裔（与非西班牙裔白人相比，OR 1.37，p =0.009）与肝硬化相关的 AIH 发病有关。西中南部（OR 1.30 与大西洋南部；p =0.008）肝硬化相关的 AIH 发病更高。
美国 AIH 的流行病学因社会人口学和地理因素而异。需要进行研究以确定 AIH 风险和结局异质性的遗传、表观遗传和环境因素。
