Type 1 autoimmune hepatitis in Taiwan: diagnosis using the revised criteria of the International Autoimmune Hepatitis Group.
Autoimmune hepatitis (AIH) is rare in Asian countries compared to the West, and an exceptionally low prevalence was noted previously in Taiwan. Using the revised criteria of the IAIHG, 48 cases of AIH patients were diagnosed. All patients were consecutively diagnosed over a period of 5 years. Detailed medical histories including disease onset, hepatitis B and C, alcohol, drugs, blood transfusion, and family history of autoimmune disease were recorded. Clinical manifestations, result of steroid therapy, outcome, and survival rate were investigated and analyzed. Clinical data on AIH patients with cirrhosis and without cirrhosis were compared and analyzed for their outcome. The statistical methods used were Fisher's exact test, Wilcoxon rank sum test, and Kaplan-Meier curve. Forty-eight patients were diagnosed as AIH type 1, with a median age of 58 years and a female:male ratio of 37:11. The most common clinical features at presentation were fatigue, jaundice, and anorexia. Ninety-eight percent of patients were ANA positive, and most of the patients showed elevated values of AST, ALT, serum globulin, and bilirubin. A substantial proportion of patients presented with poor liver function at entry and 35% of patients had liver cirrhosis, with relatively prolonged PT (P=0.001) and poorer outcome (P=0.005) compared to the noncirrhotics. As a whole there was a favorable treatment response and the overall survival rate was 85%. We conclude that the incidence of AIH in Taiwan is much higher than previously presumed and AIH type 1 is the predominant type of the disease. Although a substantial proportion of AIH patients presented with poor hepatic function at entry, as a whole there was a favorable clinical outcome.
Koay
Lok-Beng
LB
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Medical Center, 901 Chung Hwa Road, Yung Kang City, Tainan, Taiwan, ROC. 860316@mail.chimei.org.tw
Lin
Ching-Yih
CY
Tsai
Sun-Lung
SL
Lee
Chuan
C
Lin
Ching-Nan
CN
Sheu
Ming-Juen
MJ
Kuo
Hsing-Tao
HT
Sun
Chi-Shu
CS
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005805:Genes, MHC Class I; D005802:Genes, MHC Class II; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology