B0535 - Incidence of Coccidioidomycosis Infections in Endemic Region Among Patients With Autoimmune Hepatitis

Victor Arce, MD¹, Dayna M. Telken, DO¹, Moises Nevah Rubin, MD², Pooja Rangan, MBBS, MPH¹, Rohit Nathan, DO¹, Ma Ai Thanda Han, MD^3
1University of Arizona College of Medicine, Phoenix, AZ; ²Banner University Medical Center, University of Arizona College of Medicine, Phoenix, AZ; ³Banner University Medical Center, University of Arizona, Phoenix, AZ

Introduction: Coccidioidomycosis is a dimorphic yeast endemic to the southwestern United States. In most patients, infections are often asymptomatic making detection of the fungi difficult unless a strong index of suspicion is present. Immunocompromised patients can have higher rates of complications such as meningitis, lytic bone lesions, and chronic pneumonia. Patients with autoimmune hepatitis in an endemic region present a unique group of patients who possibly could face more severe disease and most require immunosuppression. We set out to determine the incidence of coccidioidomycosis in patients with autoimmune hepatitis (AIH) to better understand the epidemiology of this disease in this patient population.

Methods: Patients with the diagnosis of autoimmune hepatitis were queried in the Banner Health System from the period of January 1st, 2016 to December 31st, 2021. The chart was queried for Coccidioidomycosis IgM antibody testing as well as sex, and race. Patients were excluded if they lived outside of the endemic regions of Arizona, Colorado, New Mexico and Utah. STATA was used to perform statistical analysis and pearson chi squared testing was used to determine if statistically significant differences were present.

Results: A total of 1680 patients with autoimmune hepatitis were included. Queried from January 1st, 2016 to December 31st, 2021 period with the diagnosis of coccidioidomycosis. The mean age (SD) was 57.1 (17.8) and 1304 (77.6%) patients were female and 376 (22.4%) males. 352 (20.9%) of these patients were tested for coccidioidomycosis. Of these, 28 were positive. The incidence rate of coccidioidomycosis in patients with AIH for this study was found to be 1667 per 100,000.

Discussion: This study demonstrates a greater incidence of coccidioidomycosis infections in patients with autoimmune hepatitis compared to the general population. 1667 per 100,000 vs 98 per 100,000 as reported by the Arizona Department Public Health in 2017. The factors that can explain this are beyond the scope of this study. Further research needs to be undertaken to determine if patients with autoimmune hepatitis experience greater disease severity and hospitalization rates compared to the general population. This research may help further standardize immunosuppressive treatment for autoimmune hepatitis patients.


Disclosures:


Victor Arce, MD¹, Dayna M. Telken, DO¹, Moises Nevah Rubin, MD², Pooja Rangan, MBBS, MPH¹, Rohit Nathan, DO¹, Ma Ai Thanda Han, MD³. B0535 - Incidence of Coccidioidomycosis Infections in Endemic Region Among Patients With Autoimmune Hepatitis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.