Increased incidence of autoimmune hepatitis.

Autoimmune hepatitis is a chronic liver disease caused by a person’s defense cells attacking their own liver. This leads to a process of inflammation and destruction that can result in cirrhosis and liver cancer.

Diagnosis autoimmune hepatitis It is carried out by testing the blood for the presence of autoantibodies (antinuclear, anti-smooth muscle, anti-mitochondrial, anti-LCM) and quantitative determination of immunoglobulins. However, 25% of autoimmune hepatitis are asymptomatic. in addition, 10% of them do not have any of the mentioned analytical signs, so they are difficult to diagnose and can only be determined by liver biopsy.

An article was recently published in the magazine Lancet which analyzes the frequency of autoimmune hepatitis in the general population. The analysis included 55,839 patients from North America, Europe, Asia and Oceania. It has been proven that women suffer from autoimmune hepatitis more often than men, as do people over 65 years of age.

How did the incidence of hepatitis develop?

It has been established that the prevalence of autoimmune hepatitis increases over time. Thus, in the period from 1970 to 1999, this prevalence was 9.95 cases per 100,000 inhabitants, and from 2015 to 2022 it increased to 27.91 cases per 100,000 inhabitants. This indicates that the prevalence of autoimmune hepatitis has tripled since 2000.

There are several factors that may explain this increase. First, obesity, a risk factor for autoimmune hepatitis, has increased in recent years among the general population. The use of certain antibiotics (nitrofurantoin, minocycline) has also been associated with the development of autoimmune hepatitis. In addition, improvements in living conditions, habits and nutrition over time can influence the intestinal bacterial flora, may contribute to the development of autoimmune hepatitis

Moreover, it has been shown that with economic development, the incidence of infectious diseases decreases, but the incidence of allergies and autoimmune diseases increases. Thus, in Spain, with improving economic conditions infectious diseases have decreased. (eg, hepatitis A), and the incidence of autoimmune hepatitis has increased. On the other hand, in underdeveloped countries, some diagnostic tests for autoimmune hepatitis are not performed, so its incidence may be underestimated as it remains undiagnosed.

He Dr. Carreno and his team have noticed a significant increase in the number of patients with autoimmune hepatitis in recent years. It should be noted that, in our experience, with appropriate treatment, normalization of liver parameters is achieved in more than 40% of cases.