Patients With Autoimmune Hepatitis and Nonalcoholic Fatty Liver Disease

医学 自身免疫性肝炎 非酒精性脂肪肝 内科学 胃肠病学 肝移植 肝硬化 肝活检 肝病 重叠综合征 脂肪肝 肝炎 疾病 移植 活检
作者
Jessica Strzepka,Benjamin Schwartz,Ethan M. Ritz,Costica Aloman,Nancy Reau
出处
期刊:Journal of Clinical Gastroenterology [Ovid Technologies (Wolters Kluwer)]
卷期号:58 (1): 91-97 被引量:3
标识
DOI:10.1097/mcg.0000000000001817
摘要

Goal: The objective of this study was to characterize an autoimmune hepatitis (AIH)/nonalcoholic fatty liver disease (NAFLD) overlap cohort, determine if they received standard of care treatment, and delineate their outcomes in comparison with patients with AIH or NAFLD alone. Background: AIH is a relatively rare and heterogeneously presenting liver disease of unknown etiology. NAFLD is a leading cause of liver disease worldwide. AIH treatment includes steroids, which have adverse metabolic effects that can worsen NAFLD. No treatment guidelines are available to mitigate this side on AIH/NAFLD overlap patients. Few studies to date have examined these patients’ characteristics, management practices, and outcomes. Materials and Methods: A single-center, retrospective chart review study examining biopsy-proven AIH/NAFLD, AIH, and NAFLD patients. Characteristics, treatment, and 1- and 3-year outcomes (all-cause mortality, need for liver transplantation, or decompensated cirrhosis) were evaluated. Results: A total of 72 patients (36.1% AIH/NAFLD, 34.7% AIH, and 29.2% NAFLD) were included. AIH/NAFLD patients were found to be more often Hispanic/Latino, female, and with lower liver aminotransaminases, immunoglobulin G, and anti–smooth muscle antibody positivity. AIH/NAFLD patients were less likely to receive standard of care treatment. No significant differences in outcomes were seen between AIH/NAFLD and either AIH or NAFLD. Conclusions: Our study demonstrated that AIH/NAFLD patients have unique characteristics and are less likely to receive standard of care treatment compared with patients with AIH alone. Despite this, no difference in outcomes (all-cause mortality, need for liver transplantation, or decompensated cirrhosis) was seen. Given NAFLD’s rising prevalence, AIH/NAFLD cases will likely increase, and may benefit from alternative treatment guidelines to prevent worsening of NAFLD.
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