title: The impact of race/ethnicity on the clinical epidemiology of autoimmune hepatitis.
abstract: OBJECTIVE
  To evaluate race/ethnicity-specific variations in autoimmune hepatitis (AIH) with a focus on Asians and Hispanics, the fastest growing populations in the United States.
  
  
  BACKGROUND
  AIH is a chronic inflammatory disease in which race/ethnicity-specific variations in clinical epidemiology have been reported. However, earlier studies were small or did not include a comprehensive analysis of Asians and Hispanics, the 2 fastest growing population cohorts in the United States.
  
  
  METHODS
  A retrospective study analyzing patient data from 1999 to 2010 in a large tertiary-care community hospital to assess AIH epidemiology among a racially diverse population.
  
  
  RESULTS
  One hundred eighty-three patients with AIH were included in the study with 81 patients having "definite" AIH by International Autoimmune Hepatitis Group criteria and 63 were diagnosed with overlap syndromes. Women and whites were the largest cohorts. The average age of diagnosis was similar among all groups. Biopsy-confirmed cirrhosis was present in 34% of AIH patients with Hispanics demonstrating the highest prevalence of cirrhosis (55%). When compared with whites, Asians had higher international normalized ratio (INR) (1.4 U vs. 1.1 U, P<0.01), and Hispanics had lower serum albumin (3.3 g/dL vs. 3.7 g/dL, P<0.001) and platelets (123.8 thousand/mcL vs. 187.5 thousand/mcL, P<0.001) and higher international normalized ratio (1.5 U vs. 1.1 U, P=0.05). Kaplan-Meier survival analysis demonstrated a trend toward worse outcomes among Asians.
  
  
  CONCLUSIONS
  Among AIH patients, Hispanics had the highest prevalence of cirrhosis, and Asians had poorer survival outcomes. Race/ethnicity-specific disparities in AIH epidemiology may reflect underlying genetic differences, contributing to variations in disease severity, response to therapy, and overall mortality.
authors.affiliation: Department of Medicine, California Pacific Medical Center, San Francisco, CA 94115, USA. RobertWong123@gmail.com
authors.forename: Robert John
authors.initials: RJ
authors.lastname: Wong
authors.forename: Robert
authors.initials: R
authors.lastname: Gish
authors.forename: Todd
authors.initials: T
authors.lastname: Frederick
authors.forename: Natalie
authors.initials: N
authors.lastname: Bzowej
authors.forename: Catherine
authors.initials: C
authors.lastname: Frenette
mesh_terms: D000328:Adult; D001213:Asian / Q000235:genetics / Q000706:statistics & numerical data; D002908:Chronic Disease; D005006:Ethnicity; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology; D019693:Hepatitis, Autoimmune / Q000453:epidemiology* / Q000208:ethnology* / Q000503:physiopathology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000208:ethnology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D044465:White People / Q000235:genetics / Q000706:statistics & numerical data