Autoimmune hepatitis in diverse ethnic populations and geographical regions

作者：Czaja Albert J^*

来源：Expert Review of Gastroenterology and Hepatology, 2013, 7(4): 365-385.

DOI：10.1586/EGH.13.21

• autoimmune hepatitis
• cholestasis
• ethnic background
• genetic predispositions
• non-white patients
• regional differences

Autoimmune hepatitis has diverse clinical phenotypes and outcomes in ethnic groups within a country and between countries, and these differences may reflect genetic predispositions, indigenous etiological agents, pharmacogenomic mechanisms and socioeconomic reasons. In the USA, African-American patients have cirrhosis more commonly, treatment failure more frequently and higher mortality than white American patients. Survival is poorest in Asian-American patients. Autoimmune hepatitis in other countries is frequently associated with genetic predispositions that may favor susceptibility to indigenous etiological agents. Cholestatic features influence treatment response; acute-on-chronic liver disease increases mortality and socioeconomic and cultural factors affect prognosis. Ethnic-based deviations from classical phenotypes and the frequency of late-stage disease can complicate the diagnosis and management of autoimmune hepatitis in non-white populations.

• 出版日期2013-5