Hepatology International

, Volume 7, Issue 3, pp 869–875 | Cite as

Autoimmune hepatitis: the role of environmental risk factors: a population-based study

  • Jing H. Ngu
  • Richard B. Gearry
  • Chris M. Frampton
  • Catherine A. M. Stedman
Original Article

Abstract

Purpose

The etiology of autoimmune hepatitis (AIH) likely involves a complex interaction of genetic and environmental factors. We aim to investigate the associations between exposure to putative environmental factors and AIH and to quantify AIH risk in a first-degree relative.

Methods

We conducted a population-based case-control study. Cases were AIH patients who were alive and resided in Canterbury, New Zealand, between 1 July 2011 and 30 June 2012. Controls were randomly selected from the Electoral Roll and were matched 2:1 to each case by age and gender. Self-reporting questionnaires that cover lifestyle factors, childhood factors and family history were used.

Results

72 AIH cases and 144 controls were included. We found that exposure to antibiotics within 12 months prior to AIH diagnosis (OR 12.98, 95 % CI 2.49–67.67, p < 0.01) was an independent risk factor for the development of AIH. Alcohol consumption (OR 0.43, 95 % CI 0.28–0.68, p < 0.01) and childhood home with wood heating (OR 0.30, 95 % CI 0.14–0.63, p < 0.01) were independently associated with reduced risks of later development of AIH. The crude risk of AIH in first-degree relatives of a patient with AIH was 0.2 % (95 % CI <0.1–2.0).

Conclusions

We found that antibiotics are an independent risk factor for the development of AIH, whereas alcohol consumption and living in a childhood home with wood heating are independent protective factors against the later development of AIH.

Keywords

Autoimmune hepatitis Environmental Risk factors Pathogenesis 

Abbreviations

AIH

Autoimmune hepatitis

HLA

Human leukocyte antigen

OR

Odd ratios

CI

Confidence interval

IBD

Inflammatory bowel disease

NZSEI-96

New Zealand socio-economic index 1996

SLE

Systemic lupus erythematous

MHC

Major histocompatibility complex

Notes

Acknowledgments

Financial support for this study was provided by the Royal Australasia College of Physicians, New Zealand. Dr. Ngu is the recipient of a Clinical Fellowship from the Health Research Council of New Zealand.

Conflict of interest

Jing H. Ngu, Richard B. Gearry, Chris M. Frampton, and Catherine A.M. Stedman declare that they have no conflict of interest.

Compliance with Ethical Requirements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Upper South A Regional Ethics Committee of New Zealand, approval no. URA/10/07/055) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study.

Supplementary material

12072_2013_9448_MOESM1_ESM.pdf (174 kb)
Supplementary material 1 (PDF 174 kb)

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Copyright information

© Asian Pacific Association for the Study of the Liver 2013

Authors and Affiliations

  • Jing H. Ngu
    • 1
    • 2
  • Richard B. Gearry
    • 1
    • 2
  • Chris M. Frampton
    • 1
  • Catherine A. M. Stedman
    • 1
    • 2
  1. 1.University of OtagoChristchurchNew Zealand
  2. 2.Department of GastroenterologyChristchurch HospitalChristchurchNew Zealand

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