Global incidence and prevalence of autoimmune hepatitis, 1970–2022: a systematic review and meta-analysis

Hahn, Jong Woo; Yang, Hye Ran; Moon, Jin Soo; Chang, Ju Young; Lee, Kwanjoo; Kim, Gi Ae; Rahmati, Masoud; Koyanagi, Ai; Smith, Lee; Kim, Min Seo; López Sánchez, Guillermo F.; Elena, Dragioti; Shin, Ju-Young; Shin, Jae Il; Kwon, Rosie; Kim, Soeun; Kim, Hyeon Jin; Lee, Hojae; Ko, Jae Sung; Yon, Dong Keon

doi:10.1016/j.eclinm.2023.102280

Cited by 9 publications

(7 citation statements)

References 72 publications

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“…A recent systematic review and meta‐analysis demonstrated the gradual increase in the incidence and prevalence of AIH with the highest rates observed in adults aged over 65 years and the lowest in children 5 . A similar observation, also reflected by our findings, can be explained by the progressive aging of the general population in Italy, where the number of people who are ≥60 years old in 2020 has doubled compared with 1980 and the mean age of Italian population increased from 41.9 years in 2002 to 45.7 years in 2020 21 .…”

Section: Discussionmentioning

confidence: 99%

“…Since its first formal description in the fifties, there have been several insights into pathogenesis and major advances in the diagnostic assessment and treatment options 3,4 . AIH is considered relatively rare, as its prevalence ranges from 16 to 18 cases per 100 000 inhabitants in Europe, although its incidence and global burden are rising 5,6 . As the general population is experiencing relevant changes in its composition and distribution, the phenotype of the disease is also expected to encounter significant mutations in terms of demographic and clinical manifestations.…”

Section: Introductionmentioning

confidence: 99%

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The evolving phenotype of autoimmune hepatitis across the millennium: The 40‐year experience of a referral centre in Italy

Ferronato,

Lalanne,

Quarneti

et al. 2024

Liver International

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Background and AimsDuring recent years, there have been major insight into the pathogenesis, diagnosis and treatment of autoimmune hepatitis (AIH). We aim to evaluate modifications of the clinical‐epidemiological phenotype of AIH patients from 1980 to our days.MethodsSingle‐centre, tertiary care retrospective study on 507 consecutive Italian patients with AIH. Patients were divided into four subgroups according to the decade of diagnosis: 1981–1990, 1991–2000, 2001–2010 and 2011–2020. We assessed clinical, laboratory and histological features at diagnosis, response to treatment and clinical outcomes. Acute presentation is defined as transaminase levels >10‐fold the upper limit and/or bilirubin >5 mg/dL. Complete response is defined as the normalization of transaminases and IgG after 12 months. Clinical progression is defined as the development of cirrhosis in non‐cirrhotic patients and hepatic decompensation/hepatocellular carcinoma development in compensated cirrhosis.ResultsMedian age at diagnosis increased across decades (24, 31, 39, 52 years, p < .001). Acute onset became more common (39.6%, 44.4%, 47.7%, 59.5%, p = .019), while cirrhosis at diagnosis became less frequent (36.5%, 16.3%, 10.8%, 8.7%, p < .001). Complete response rates rose (11.1%, 49.4%, 72.7% 76.2%, p < .001) and clinical progression during follow‐up decreased (54.3%, 29.9%, 16.9%, 11.2%, p < .001). Anti‐nuclear antibodies positivity increased (40.7%, 52.0%, 73.7%, 79.3%, p < .001), while IgG levels/upper limit progressively decreased (1.546, 1.515, 1.252, 1.120, p < .001). Liver‐related death and liver transplantation reduced from 17.1% to 2.1% (p < .001).ConclusionsIn the new millennium, the typical AIH patient in Italy is older at diagnosis, more often presents with acute hepatitis, cirrhosis is less frequent and response to treatment is more favourable.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The evolving phenotype of autoimmune hepatitis across the millennium: The 40‐year experience of a referral centre in Italy

Ferronato,

Lalanne,

Quarneti

et al. 2024

Liver International

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“…We extracted the following data from each published study: first author, publication year, country, sample size, patient information (polymerase chain reaction‐confirmed monkeypox, people living with human immunodeficiency virus [PLHIV], age, and sex), data collection method (single centre, multicenter, and unknown), study date, study design (cohort, cross‐sectional, and case series), and clinical features and outcomes of MPXV infection. To analyse the collected studies, the Der Simonian and Laird random effects model were used to calculate the pooled prevalence along with the 95% confidence intervals (CIs), and then the prevalence of each symptom and clinical outcome before (2003–2021) and during the 2022 mpox outbreak were compared, to determine the relative ratio (RR) and its corresponding 95% CI 14,15 . A meta‐analysis was conducted using the R software (version 4.2.1; R Foundation, Vienna, Austria).…”

Section: Methodsmentioning

confidence: 99%

“…To analyse the collected studies, the Der Simonian and Laird random effects model were used to calculate the pooled prevalence along with the 95% confidence intervals (CIs), and then the prevalence of each symptom and clinical outcome before (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020)(2021) and during the 2022 mpox outbreak were compared, to determine the relative ratio (RR) and its corresponding 95% CI. 14,15 A meta-analysis was conducted using the R software (version 4.2.1; R Foundation, Vienna, Austria). A two-sided p value of less than 0.05 was considered significant.…”

Section: Methodsmentioning

confidence: 99%

Clinical characteristics and outcomes of patients with mpox during the 2022 mpox outbreak compared with those before the outbreak: A systematic review and meta‐analysis

Cho,

Park,

Kim

et al. 2024

Reviews in Medical Virology

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On 23 July 2022, the World Health Organization declared the global mpox outbreak as a public health emergency of international significance. The mpox virus (MPXV) that caused the outbreak was classified as clade IIb, which belongs to the West African clade. However, the relationship between MPXV clades and symptoms, as well as the severity of mpox outcomes, is not fully understood. Thus, we aimed to investigate the global mpox prevalence and the differences in clinical manifestations and outcomes among patients with mpox between pre‐outbreak (2003–2021) and the current mpox outbreak. In this systematic review and meta‐analysis, PubMed/MEDLINE, Web of Science, Embase, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar were searched using the keyword “monkeypox” and “mpox” up to 13 October 2022. A random effects model was used to obtain the pooled prevalence and 95% confidence intervals. This study included 27 articles, and 5698 patients with mpox with 19 distinctive features from 19 countries across five continents were assessed. Patients with mpox during the 2022 mpox outbreak showed mild clinical manifestations and outcomes compared with those before the 2022 mpox outbreak: mild rash (relative ratio [RR]: 5.09, 95% confidence interval [CI]: 1.52–17.08), fever (0.68, 0.49–0.94), pruritus (0.25, 0.19–0.32), myalgia (0.50, 0.31–0.81), headache (0.56, 0.35–0.88), skin ulcer (0.32, 0.17–0.59), abdominal symptom (0.29, 0.20–0.42), pharyngitis (0.32, 0.18–0.58), nausea or vomiting (0.15, 0.02–0.93), conjunctivitis (0.11, 0.03–0.38), concomitant infection with HIV (1.70, 0.95–3 0.04), and death (0.02, 0.001–0.31). MPXV clade IIb exhibited higher infectivity but may cause mild disease symptoms and low mortality rate. It is important to consider MPXV infection in patients with mpox‐related features and/or a history of sexual transmission to prevent the spread of the disease and recognise the current pandemic threat.

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“…disease, which also showed a higher tendency for heterogeneity. 38,[43][44][45] Consequently, we refrained from conducting a meta-regression analysis due to the substantial degree of heterogeneity between studies in our analysis. Therefore, the results of our study must be interpreted with great care, considering this aspect.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Global trends in incidence and prevalence of achalasia, 1925–2021: A systematic review and meta‐analysis

Lee,

Hong,

Yoo

et al. 2024

UEG Journal

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BackgroundAchalasia poses a significant socioeconomic burden, yet global trends remain undocumented. This study aims to describe the worldwide trends in the incidence and prevalence of achalasia from 1925 to 2021 and explore their correlation with various factors through a comprehensive systematic review.MethodsWe searched the PubMed/MEDLINE, Embase, and Cochrane databases from inception to 30 June 2023, to identify studies reporting the incidence or prevalence of achalasia in the general population. This study utilized pooled estimates with 95% confidence intervals (CI) to estimate the incidence and prevalence of achalasia, and conducted various subgroup analyses.ResultsA total of 26 eligible studies covering approximately 269 million participants and 20,873 patients from 14 countries across five continents were included. Global pooled incidence and prevalence of achalasia were estimated to be 0.78 cases per 100,000 person‐years (95% CI, 0.64–0.93; number of studies, 26; sample population, 269,315,171) and 10.82 cases per 100,000 person‐years (95% CI, 8.15–13.48; number of studies, 14; sample population, 192,176,076), respectively. The incidence of achalasia was higher in Oceania (than Asia and Africa) and in adults (than children) after the introduction of the Chicago classification. Prevalence followed a similar pattern. The pooled incidence of achalasia showed an overall upward trend from 1925 to 2021 (1925–1999; 0.40 [0.32–0.49] vs. 2018–2021; 1.64 [1.33–1.95] cases per 100,000 person‐years).ConclusionsThe incidence and prevalence of achalasia have notably increased, particularly with advancements in diagnosis, and show significant variation worldwide, despite the large heterogeneity within the sample population. Further studies are necessary to accurately assess the global incidence and prevalence of achalasia.

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Global incidence and prevalence of autoimmune hepatitis, 1970–2022: a systematic review and meta-analysis

Cited by 9 publications

References 72 publications

The evolving phenotype of autoimmune hepatitis across the millennium: The 40‐year experience of a referral centre in Italy

The evolving phenotype of autoimmune hepatitis across the millennium: The 40‐year experience of a referral centre in Italy

Clinical characteristics and outcomes of patients with mpox during the 2022 mpox outbreak compared with those before the outbreak: A systematic review and meta‐analysis

Global trends in incidence and prevalence of achalasia, 1925–2021: A systematic review and meta‐analysis

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