ArticleLiver international : official journal of the International Association for the Study of the Liver2021
Environmental risk factors are associated with autoimmune hepatitis.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- British Society of Gastroenterology guidelines for diagnosis and management of autoimmune hepatitis.Gut · 2025Guideline
- Environmental shaping of tolerance failure in autoimmune liver diseases: a phenotype-specific framework with primary biliary cholangitis as the strongest model.Journal of translational autoimmunity · 2026Review
- Clinical features of acute-onset autoimmune hepatitis: a systematic review and meta-analysis.Clinics (Sao Paulo, Brazil) · 2026Review
- Autoimmune Hepatitis: A Review of Molecular Mechanisms and Research Gaps in African Populations.Biology · 2026Review
- Autoimmune liver diseases in the Asia Pacific region: proceedings of the autoimmune liver disease course at APASL 2025.Hepatology international · 2026Review
- Clinicopathological characteristics of autoimmune‑like hepatitis after drug‑induced liver injury.Biomedical reports · 2025Article
- The Effect of Age Stereotype in Elderly Adults with the Mediation Role of Self-Esteem and Sense of Coherence.Psychology research and behavior management · 2025Review
- Nicotine dependence is associated with an increased risk of developing chronic, non-communicable inflammatory disease: a large-scale retrospective cohort study.Frontiers in psychiatry · 2025Article
- Article
- Smoking is a Risk Factor for Autoimmune Hepatitis: An English Registry-Based Case-Control Study.Clinical epidemiology · 2024Article
- Nomenclature, diagnosis and management of drug-induced autoimmune-like hepatitis (DI-ALH): An expert opinion meeting report.Journal of hepatology · 2023Review
- Immune-mediated liver injury following COVID-19 vaccination.World journal of virology · 2023Review
- Clinical Characteristics of Autoimmune Hepatitis in a Middle Eastern Population: A Tertiary Care Center Experience.Journal of clinical medicine · 2023Article
- Hepatitis A: Viral Structure, Classification, Life Cycle, Clinical Symptoms, Diagnosis Error, and Vaccination.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2023Review
- Environmental risk factors are associated with autoimmune hepatitis.Liver international : official journal of the International Association for the Study of the Liver · 2021Article
- Dysfunctional Immune Regulation in Autoimmune Hepatitis: From Pathogenesis to Novel Therapies.Frontiers in immunology · 2021Review
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Authors and funding
5 authors.
Funding
Abstract
backgroundFailure of immunologic homeostasis and resultant hepatocyte destruction in autoimmune hepatitis (AIH) is likely the result of environmental triggers within a permissive genetic architecture.
aimsWe aimed to identify risk factors associated with AIH in a well-phenotyped AIH cohort.
methodsWe prospectively collected environmental questionnaires from 358 AIH cases and 563 healthy controls. Response frequencies were compared using logistic regression, adjusting for age at recruitment, sex and education.
resultsAIH cases were more likely to ever have a urinary tract infection (UTI) (53.6% vs 33.9%, P < .001) and recurrent UTI (more than 1 per year) (23.5% vs 15.9%, P = .002) compared to controls. Female cases more frequently had ever used oral contraceptives (83.0% vs 73.7%, P = .006), fewer pregnancies (median = 1 vs 3, P < .001) and less often used hormone replacement therapy compared to controls (28.5% vs 60.1%, P < .001). Current smoking was more prevalent in cases (18.9% vs 7.4%, P = .022), yet no difference according to historical smoking behaviours was observed. Finally, cases were less likely to have history of mumps (32.4% vs 53.1%, P = .011) and rheumatic fever (1.1% vs 4.4%, P = .028), but reported higher vaccination frequency to chicken pox (38% vs 28.1%), measles (66.5% vs 39.3%), mumps (58.7% vs 34.6%), rubella (55.3% vs 32.7%), pertussis (59.8% vs 40.1%) and pneumococcus (47.2% VS 39.4%) (P < .002).
conclusionsEnvironmental factors are important in AIH pathogenesis. Replication of these findings and prospective examination may provide new insight into AIH onset and outcomes.
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