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Metabolic-associated fatty liver disease and autoimmune hepatitis: an overlooked interaction
Yasmine Gaber1, Mohamed AbdAllah2, Asmaa Salama3
1Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Introduction:
Metabolic-associated fatty liver disease (MAFLD) is the most common liver disease globally, and affects about a quarter of the general population. Autoimmune hepatitis (AIH) is a severe (sometimes fatal) liver disease that affects children and adults, with a rising prevalence. Thus, not surprisingly, both conditions can frequently coexist, with potential synergistic impact on the course of the disease and response to therapy of both entities.
Areas Covered:
In this work, the authors aimed to provide a narrative updated review on this interaction, diagnosis, and management of MAFLD/AIH and the current challenges.
Expert Opinion:
Clarifying the nature of the complex interaction between the two diseases was hampered by a myriad of factors, particularly the previous diagnosis of exclusion for fatty liver disease associated with metabolic dysfunction. The recent redefinition of fatty liver disease that led to the development of positive diagnostic criteria for MAFLD has the premise to help in circumventing some of these challenges.
Insights
Metabolic-associated fatty liver disease (MAFLD) and autoimmune hepatitis (AIH) often coexist, impacting disease progression and treatment. Recent diagnostic criteria for MAFLD may improve understanding of this complex interaction.
Area of Science:
- Hepatology
- Immunology
- Gastroenterology
Background:
- Metabolic-associated fatty liver disease (MAFLD) affects approximately 25% of the global population.
- Autoimmune hepatitis (AIH) is a severe liver disease with increasing prevalence in children and adults.
- The frequent coexistence of MAFLD and AIH can synergistically affect disease course and therapeutic response.
Purpose of the Study:
- To provide an updated narrative review on the interaction between MAFLD and AIH.
- To discuss the diagnosis and management of patients with coexisting MAFLD and AIH.
- To highlight current challenges in understanding and treating these overlapping conditions.
Main Methods:
- Narrative review of existing literature.
- Analysis of diagnostic criteria and management strategies for MAFLD and AIH.
- Discussion of the challenges in differentiating and managing concurrent MAFLD/AIH.
Main Results:
- The interaction between MAFLD and AIH is complex and can influence disease outcomes.
- Diagnostic challenges were historically significant due to the previous exclusionary definition of fatty liver disease.
- The new positive diagnostic criteria for MAFLD offer potential to clarify diagnostic pathways.
Conclusions:
- The redefinition of MAFLD provides a foundation for better understanding its interaction with AIH.
- Addressing the complexities of MAFLD/AIH co-occurrence is crucial for effective patient management.
- Further research is needed to fully elucidate the synergistic effects and optimize treatment strategies.
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