Characteristics of autoimmune hepatitis in the Asia-Pacific Region: historical review.

BACKGROUND

Autoimmune hepatitis (AIH) has been considered a relatively rare disease in Asia, including Japan, where there is a high frequency of infection with hepatitis viruses.

METHOD: We reviewd the ethnic differences of clinical features of autoimmume hepatitis by reported paper.

RESULT: Immunogenetic predisposition, especially differences in human leukocyte antigens (HLAs), has been pointed out as one of the factors for the occurrence of AIH. In other words, HLA-DR3, which is the first disease-susceptibility gene for AIH discovered in UK and the USA, is extremely rare in Asia including Japan. Moreover, HLA-DR4, which is more frequent than HLA-DR3 in Asia, is associated with a favorable response to treatment and improved prognosis. This also explains why diagnosis and treatment of AIH have not drawn as much attention as viral hepatitis. However, as a survey conducted in Japan shows, the number of patients diagnosed with AIH is increasing. However, the number of elderly patients positive for HLA-DR4 is also increasing in UK and the USA.

CONCLUSION

In the era of genome-wide association studies, further progress of studies on AIH, a typical disease model for immunological liver cell damage, is expected.