Characterizing outcomes in a large cohort of latinx patients with autoimmune hepatitis

Introduction and Objectives: This study aimed to characterize a large cohort of Latinx patients with autoimmune hepatitis (AIH) and analyze clinical outcomes, including biochemical remission, duration of steroid treatment, fibrosis regression, and incidence of clinical endpoints (hepatic decompensat...

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Main Authors: Eleanor Belilos, Jessica Strzepka, Ethan Ritz, Nancy Reau, Costica Aloman
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Annals of Hepatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1665268124003533
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author Eleanor Belilos
Jessica Strzepka
Ethan Ritz
Nancy Reau
Costica Aloman
author_facet Eleanor Belilos
Jessica Strzepka
Ethan Ritz
Nancy Reau
Costica Aloman
author_sort Eleanor Belilos
collection DOAJ
description Introduction and Objectives: This study aimed to characterize a large cohort of Latinx patients with autoimmune hepatitis (AIH) and analyze clinical outcomes, including biochemical remission, duration of steroid treatment, fibrosis regression, and incidence of clinical endpoints (hepatic decompensation, need for liver transplant, and death). Materials and Methods: This was a retrospective descriptive study of patients with biopsy proven AIH (2009–2019) at a single urban center. Demographics, medical comorbidities, histology, treatment course, biochemical markers, fibrosis using dynamic non-invasive testing (NIT), and clinical outcomes at three months and at one, two, and three years were analyzed. Results: 121 adult patients with biopsy-proven AIH were included: 43 Latinx (35.5%) and 78 non-Latinx (65.5%). Latinx patients were more likely to have metabolic dysfunction-associated steatotic liver disease (MASLD) (p = 0.004), and had higher Fibrosis-4 (FIB-4) (p = 0.0279) and AST-to-Platelet-Ratio-Index (APRI) (p = 0.005) at one year. Latinx patients took longer to reach biochemical remission than non-Hispanic Whites (p = 0.031) and longer to stop steroids than non-Hispanic Blacks (p = 0.016). There were no significant differences based on ethnicity in histological fibrosis stage at presentation or incidence of clinical endpoints. Conclusions: MASLD overlap is highly prevalent in Latinx AIH patients. Longer time to biochemical remission and worse NITs support that this population may have slower fibrosis regression with standard of care AIH treatment. This may indicate differing response rates due to genetic polymorphisms affecting drug metabolism and immune response among Latinx individuals and is less likely related to AIH/MASLD overlap based on the findings of this study.
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spelling doaj-art-b6e1b2eb9b6b4d888171ddc61f8a47b52025-08-20T02:04:49ZengElsevierAnnals of Hepatology1665-26812025-01-0130110157010.1016/j.aohep.2024.101570Characterizing outcomes in a large cohort of latinx patients with autoimmune hepatitisEleanor Belilos0Jessica Strzepka1Ethan Ritz2Nancy Reau3Costica Aloman4Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA; Corresponding author.Department of Internal Medicine, Division of Digestive Diseases and Nutrition, Rush University Medical Center, Chicago, IL, USADepartment of Internal Medicine, Division of Digestive Diseases and Nutrition, Rush University Medical Center, Chicago, IL, USADepartment of Internal Medicine, Division of Digestive Diseases and Nutrition, Rush University Medical Center, Chicago, IL, USADepartment of Internal Medicine, Rush University Medical Center, Chicago, IL, USA; Department of Internal Medicine, Division of Digestive Diseases and Nutrition, Rush University Medical Center, Chicago, IL, USA; Department of Internal Medicine, New York Medical College, Westchester Medical Center, Vahalla, NY, USAIntroduction and Objectives: This study aimed to characterize a large cohort of Latinx patients with autoimmune hepatitis (AIH) and analyze clinical outcomes, including biochemical remission, duration of steroid treatment, fibrosis regression, and incidence of clinical endpoints (hepatic decompensation, need for liver transplant, and death). Materials and Methods: This was a retrospective descriptive study of patients with biopsy proven AIH (2009–2019) at a single urban center. Demographics, medical comorbidities, histology, treatment course, biochemical markers, fibrosis using dynamic non-invasive testing (NIT), and clinical outcomes at three months and at one, two, and three years were analyzed. Results: 121 adult patients with biopsy-proven AIH were included: 43 Latinx (35.5%) and 78 non-Latinx (65.5%). Latinx patients were more likely to have metabolic dysfunction-associated steatotic liver disease (MASLD) (p = 0.004), and had higher Fibrosis-4 (FIB-4) (p = 0.0279) and AST-to-Platelet-Ratio-Index (APRI) (p = 0.005) at one year. Latinx patients took longer to reach biochemical remission than non-Hispanic Whites (p = 0.031) and longer to stop steroids than non-Hispanic Blacks (p = 0.016). There were no significant differences based on ethnicity in histological fibrosis stage at presentation or incidence of clinical endpoints. Conclusions: MASLD overlap is highly prevalent in Latinx AIH patients. Longer time to biochemical remission and worse NITs support that this population may have slower fibrosis regression with standard of care AIH treatment. This may indicate differing response rates due to genetic polymorphisms affecting drug metabolism and immune response among Latinx individuals and is less likely related to AIH/MASLD overlap based on the findings of this study.http://www.sciencedirect.com/science/article/pii/S1665268124003533MASLDFIB-4APRIBiochemical remission
spellingShingle Eleanor Belilos
Jessica Strzepka
Ethan Ritz
Nancy Reau
Costica Aloman
Characterizing outcomes in a large cohort of latinx patients with autoimmune hepatitis
Annals of Hepatology
MASLD
FIB-4
APRI
Biochemical remission
title Characterizing outcomes in a large cohort of latinx patients with autoimmune hepatitis
title_full Characterizing outcomes in a large cohort of latinx patients with autoimmune hepatitis
title_fullStr Characterizing outcomes in a large cohort of latinx patients with autoimmune hepatitis
title_full_unstemmed Characterizing outcomes in a large cohort of latinx patients with autoimmune hepatitis
title_short Characterizing outcomes in a large cohort of latinx patients with autoimmune hepatitis
title_sort characterizing outcomes in a large cohort of latinx patients with autoimmune hepatitis
topic MASLD
FIB-4
APRI
Biochemical remission
url http://www.sciencedirect.com/science/article/pii/S1665268124003533
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