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• W3208678286 abstract "Introduction: Several cases of HIV-infected patients developing autoimmune hepatitis have been reported. T cell dysfunction has been suggested to play a significant role in the pathogenesis of autoimmune hepatitis, while HIV affects CD4+ T cells. However, there is a lack of data on how outcomes of autoimmune hepatitis may differ in HIV-infected patients. Thus, we aim to assess the outcomes of autoimmune hepatitis in patients with HIV. Methods: Adult patients hospitalized with autoimmune hepatitis from the National Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality 2010-2014 were selected. Diagnoses were identified by using ICD-9 CM codes. Patient demographics and outcomes of autoimmune hepatitis were compared between the groups with and without HIV. The outcomes of interest were inpatient mortality, length of stay, total hospital charge, and hepatic complications including cirrhosis, portal hypertension, hepatic encephalopathy, ascites, hepatorenal syndrome, varices and variceal bleeding, spontaneous bacterial peritonitis, and sepsis. Chi-squared tests and independent t-tests were used to compare proportions and means, respectively. Multivariate logistic regression analysis was performed to determine if HIV is an independent predictor for the outcomes, adjusting for age, sex, and race. Results: Among 17,963 patients hospitalized with autoimmune hepatitis, 118 patients had a history of HIV. Patients with HIV were younger (age 46.9 vs 57.1, p < 0.05), more likely to be male (41.5% vs 19.5%, p < 0.05), less likely to be White (21.9% vs 64.5%), and had longer length of stay (8.4 days vs 5.8 days, p < 0.05). Differences in total hospital charges and inpatient mortality were not statistically significant. After adjusting for age, sex, and race, HIV was an independent risk factor for sepsis (aOR 2.92, 95% CI: 1.83-4.66, p < 0.05). HIV was an independent protective factor for cirrhosis (aOR 0.64, 95% CI: 0.43-0.97, p < 0.05) and ascites (aOR 0.55, 95% CI: 0.31-0.99, p < 0.05). Adjusted odds ratios of other outcomes were not statistically significant. Conclusion: Our study indicates that autoimmune hepatitis patients with HIV have increased odds of sepsis. Increased susceptibility to invasive infections seen in patients with HIV can explain this finding. Interestingly, HIV was associated with lower risks of ascites and cirrhosis. Further studies on the precise mechanism of how autoimmune hepatitis develops in HIV infection may help answer this question." @default.
• W3208678286 created "2021-11-08" @default.
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• W3208678286 date "2021-10-01" @default.
• W3208678286 modified "2023-09-27" @default.
• W3208678286 title "S3415 Outcomes of Autoimmune Hepatitis in Hospitalized Patients with HIV" @default.
• W3208678286 doi "https://doi.org/10.14309/01.ajg.0000787192.06041.9a" @default.
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