(57) Retrospective Study Estimating the Incidence of Acute Alcoholic Hepatitis in the United Kingdom

Publication Number: 1102

Background: Alcoholic hepatitis (AH) is an inflammatory liver disease, which usually develops after long-term heavy drinking. AH is characterized by jaundice, fever, enlargement and tenderness of the liver and neutrophil infiltration and may present as chronic or acute AH. Diagnosis mainly relies on a combination of clinical suspicions, laboratory findings, and biopsy measurements. Data on the incidence of AH is scarce and no studies among paediatric population have been conducted to date.

Objectives: The study aimed to assess the incidence rates (IRs) of AH in the United Kingdom (UK) general population by age and gender.

Methods: This is a population-based study including patients of all ages registered in the UK Clinical Practice Research Datalink (CPRD) database from 2016 to 2019. The IR of AH (defined via Read code: J611, J617, J617000) was calculated overall and for each year between 2016 and 2019. The numerator was defined as number of patients newly diagnosed with AH in a given year. The denominator consisted of the person-time at risk contributed by all cohort members in that year. All patients had to be enrolled at least one year before and patients diagnosed with AH in previous years were excluded. IRs and 95% confidence intervals (CI) were also calculated by gender and age categories ( < 18 years, 18-65 years, >65 years). The study was approved by the relevant board (ISAC protocol No: 20_000122).

Results: We identified 19’269’538 patients registered in the CPRD during the study period. The number of patients with AH from 2016 to 2019 was 430; the cumulative IR was 0.57 cases per 100,000 PYs (95% CI: 0.52-0.63). The IR increased from 2016 to 2017 to a maximum of 0.64 (95% CI: 0.53-0.76) per 100,000 PY and decreased to 0.58 (95% CI: 0.48-0.70) in 2018, and 0.53 (95% CI: 0.44-0.65) in 2019. Men represented 63.7% of patients with AH, and had a cumulative IR of 0.77 per 100,000 PYs (95% CI: 0.68-0.86), whereas women represented 36.3% of patients and had a rate of 0.40 per 100,000 PYs (95% CI: 0.34-0.47). When stratified by age, no AH case was observed among patients < 18 years. Patients 18-65 years represented 92.6% of all cases over the entire study period. The cumulative IR within this age group (18-65 years) was 0.78 (95% CI: 0.70-0.86) per 100,000 PYs. Patients above 65 years had an IR of 0.21 (95% CI: 0.14-0.29) per 100,000 PYs

Conclusions: This is the first study, which evaluates the IR of AH by age and gender over time in the UK. The IR of AH did not significantly change over time. Men had higher annual IRs than women. We found no cases of AH among pediatric population. The highest IR of AH was among patients 18-65 years, so any intervention would be most beneficial among this group of patients.