Delgado J, Fuentes M, Simian D, Poniachik J, Urzúa Á. Impact of age on autoimmune hepatitis: A comparative study of patients diagnosed before and after sixty. World J Hepatol 2025; 17(12): 110312 [DOI: 10.4254/wjh.v17.i12.110312]
Corresponding Author of This Article
Álvaro Urzúa, MD, Division of Gastroenterology, Department of Medicine, Hospital Clínico Universidad de Chile, Dr. Carlos Lorca Tobar 999, Independencia, Santiago 8380456, Región Metropolitana, Chile. aurzuam@hcuch.cl
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Gastroenterology & Hepatology
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Retrospective Cohort Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 27, 2025 (publication date) through Dec 29, 2025
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World Journal of Hepatology
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1948-5182
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Delgado J, Fuentes M, Simian D, Poniachik J, Urzúa Á. Impact of age on autoimmune hepatitis: A comparative study of patients diagnosed before and after sixty. World J Hepatol 2025; 17(12): 110312 [DOI: 10.4254/wjh.v17.i12.110312]
World J Hepatol. Dec 27, 2025; 17(12): 110312 Published online Dec 27, 2025. doi: 10.4254/wjh.v17.i12.110312
Impact of age on autoimmune hepatitis: A comparative study of patients diagnosed before and after sixty
Javier Delgado, Marcelo Fuentes, Daniela Simian, Jaime Poniachik, Álvaro Urzúa
Javier Delgado, Marcelo Fuentes, Daniela Simian, Jaime Poniachik, Álvaro Urzúa, Division of Gastroenterology, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago 8380456, Región Metropolitana, Chile
Author contributions: Delgado J wrote the manuscript draft; Delgado J and Fuentes M collected the data; Delgado J, Simian D, and Urzúa A designed the study; Simian D performed the data analysis; Delgado J, Fuentes M, Simian D, Poniachik J, and Urzúa A reviewed and edited the final version of the manuscript.
Institutional review board statement: The study was approved by the local Ethics Committee of Hospital Clínico Universidad de Chile (N° 52/2023).
Informed consent statement: The study was approved by the local Ethics Committee of Hospital Clínico Universidad de Chile (N° 52/2023), which waived informed consent due to the retrospective nature of the research. Data confidentiality and security were ensured during data collection and analysis, with anonymized data used for statistical evaluations.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Álvaro Urzúa, MD, Division of Gastroenterology, Department of Medicine, Hospital Clínico Universidad de Chile, Dr. Carlos Lorca Tobar 999, Independencia, Santiago 8380456, Región Metropolitana, Chile. aurzuam@hcuch.cl
Received: June 12, 2025 Revised: July 1, 2025 Accepted: November 17, 2025 Published online: December 27, 2025 Processing time: 197 Days and 20.5 Hours
Abstract
BACKGROUND
Autoimmune hepatitis (AIH) is characterized by inflammation, hepatocyte necrosis, autoantibodies, and elevated serum globulin levels. It can present at any age, with peaks reported at 30 years and after 60 years. No national studies have evaluated the impact of age at diagnosis on AIH presentation and outcomes.
AIM
To compare the presentation and progression of AIH in patients diagnosed before and after the age of 60 years.
METHODS
This cross-sectional analytical study included biopsy-confirmed AIH patients with at least one year of follow-up at Hospital Clínico Universidad de Chile, Santiago, Chile. Demographic, clinical, laboratory, and treatment response variables were analyzed. Group comparisons (diagnosis before or after 60 years) were performed using the χ2 test for qualitative variables and the Mann-Whitney test for quantitative variables (significance P < 0.05).
RESULTS
Ninety-seven AIH patients were included; 85% were female, with a median age of 53 years (range 18-83 years). Forty-one percent were diagnosed after the age of 60. Younger patients exhibited more jaundice at diagnosis (75% vs 44%, P = 0.02) and higher aminotransferases levels (median alanine aminotransferase 998 IU/mL vs 334 IU/mL, P = 0.0002). In contrast, at diagnosis, ascites was more prevalent in patients over 60 (13% vs 2%, P = 0.028), and advanced fibrosis (F3-F4) was more frequent in this group (68% vs 41%, P = 0.020). Biochemical response at six months was similar between groups, despite lower corticosteroid doses being administered to patients over 60 years.
CONCLUSION
AIH in patients over 60 presented with less jaundice, lower aminotransferases levels, greater fibrosis, and more ascites. Biochemical response was similar independently of age and despite lower prednisone doses administered in patients over 60 years.
Core Tip: This study highlights age-related differences in autoimmune hepatitis (AIH) presentation. Patients diagnosed after 60 years of age showed milder biochemical abnormalities but more advanced fibrosis and ascites at diagnosis. Despite receiving lower corticosteroid doses, their treatment response was comparable to younger patients. These findings suggest that AIH in older adults may represent a distinct clinical phenotype with important diagnostic and therapeutic implications.
