Introduction Autoimmune hepatitis (AIH) is a disease of unknown aetiology characterised by interface hepatitis, hypergammaglobulinaemia and circulating autoantibodies.1,2 It is associated with Human leucocyte antigen (HLA) DR3/DR4 allotypes which are common in European Caucasian population.2 Previous published studies reported late clinical presentations and poor outcome in non-Caucasian ethnic groups.
Methods This is a retrospective analysis of patients with type 1 AIH at a single centre tertiary liver transplant unit between year 1995 and 2012. Patients with simplified AIH score of more than or equal to 6 were included in the study. Data were collected thoroughly from electronic case notes, clinical letters and treatment charts. Basic demographics, clinical presentations, blood parameters such as biochemistry and immunology, liver histology and presence of other associated autoimmune conditions were documented. Those factors were compared among three ethnic groups: Caucasian, Asian and Black-African.
Results A total of 190 patients are included in the study. The majority (78%) of AIH patients are females. Majority (84%) were Caucasian and Asian ethnicity constitutes 12% of the study population with the remainder (4%) being Black ethnicity. Age of diagnosis is slightly higher among Caucasian groups although non-significantly (Median age 50.5 vs 34.9 in Asian and 45.3 in Black).
No significant differences were detected for associated autoimmune conditions, DR3/DR4 association or liver biochemistry blood results among three ethnic groups. Immunoglobulin G and Immunoglobulin A are significantly lower in Caucasian compared to non-Caucasian populations (p = 0.029, 0.005 respectively). There are no differences in clinical outcomes such as cirrhosis, development of hepatocellular carcinoma (HCC) or liver decompensation among three different ethnic groups.
Conclusion Clinical presentations and blood parameters were similar among three groups except Ig G and Ig A which were lower in Caucasian ethnic populations. Overall transplant free survival was similar among the three groups
Zachou K, et al. Review article: autoimmune hepatitis – current management and challenges. Alimentary Pharmacology and Therapeutics 2013. 38(8):887–913
Albert J, Czaja PTD. Genetic susceptibilities for immune expression and liver cell injury in autoimmune hepatitis. Immunological Reviews 2000;174:250–259
Disclosure of Interest None Declared.
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