The demographics of autoimmune hepatitis in human immunodeficiency virus-infected patients: a United States cross-sectional study

Introduction
Autoimmune hepatitis (AIH) is a chronic inflammatory condition of the liver with increasing global prevalence. However, no epidemiological data exist for AIH in human immunodeficiency virus (HIV)-infected patients.

Aim
To determine the demographics and comorbid conditions associated with AIH among HIV-infected individuals in the United States.

Material and methods
The United States National Inpatient Sample database was used to identify HIV hospital encounters in 2012–2014. The encounters were then classified into 2 groups based on a concomitant primary diagnosis of AIH. Primary outcomes included the demographics and comorbid conditions of AIH among HIV-infected patients. Secondary outcomes assessed the independent predictors of AIH.

Results
A total of 48,3310 patients with an HIV diagnosis were included. The estimated AIH prevalence was 52.8/100,000 HIV hospital encounters. The female gender was more likely to have AIH with an odds ratio (OR) of 1.82; 95% confidence interval (CI) 1.42–2.32, p < 0.0001. The age intervals of 35–50 and 51–65 years had higher odds of AIH 110 (43.1%) and 115 (45.1%) with OR = 1.30; 95% CI: 1.02–1.67, p = 0.03 and OR = 1.34; 95% CI: 1.05–1.71, p = 0.02, respectively. African American and Hispanic races were more commonly affected. Moreover, HIV-infected patients with AIH had a higher risk of having elevated transaminases, long-term steroid use, rheumatoid arthritis, and ulcerative colitis.

Conclusions
This study illustrates that the estimated prevalence of AIH in HIV-infected patients in the United States is 52.8/100,000. AIH in HIV-positive individuals has a predilection for the female gender and African American and Hispanic races, and shows a higher correlation with rheumatoid arthritis and ulcerative colitis.