Increased Mortality Risk in Autoimmune Hepatitis: A Nationwide Population-Based Cohort Study With Histopathology

• DOI: 10.1016/j.cgh.2020.10.006
• Publication Date: 2020-10-14T02:25:32Z
• Authors: Rajani Sharma; Elizabeth C. Verna; Jonas Söderling; Bjorn Roelstraete; Hannes Hagström; Jonas F. Ludvigsson
• Keywords: Autoimmune Hepatitis; Histopathology

Background and AimsAutoimmune hepatitis (AIH) is a chronic inflammatory liver disease that may lead to cirrhosis failure, but data on overall mortality in AIH are conflicting.MethodsThis was nationwide population-based cohort study Sweden from 1969-2017 of 6,016 adults with 28,146 matched general population reference individuals. defined by combination medical diagnosis plus biopsy any Sweden's 28 pathology departments. Through Cox regression, we estimated hazard ratios (HRs) for cause-specific death. Liver transplant included our main outcome death.ResultsDuring follow-up, 3,185 individuals died (41.4/1000 person-years) compared 10,477 (21.9/1000 person-years). The 10-year cumulative incidence death 32.3% (95%CI = 31.1-33.6) 14.1% 13.7-14.5) This corresponded an adjusted HR 2.29 2.17-2.41), which remained elevated ≥20 years follow-up. had high risk (HR 4.55; 95%CI 3.95-5.25), while patients fibrosis, inflammation without or necrosis did not differ. Portal hypertension overlap cholestatic diseases were also associated increased cardiovascular 1.27; 1.15-1.40), 66.24; 48.19-91.03) extrahepatic malignancy 1.69; 1.51-1.89). In sibling comparison, at death.ConclusionAIH 2-fold Risks particularly cirrhosis, portal hypertension, disease. Autoimmune conflicting. During