Diagnosis and presenting features of autoimmune hepatitis at a central referral hospital in South Africa


  • Y Maharaj Division of Internal Medicine, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa https://orcid.org/0009-0006-6194-7419
  • V G Naidoo Department of Gastroenterology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; Gastrointestinal Cancer Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa https://orcid.org/0000-0003-3774-9608




South Africa, autoimmune hepatitis, cirrhosis, HIV



Autoimmune hepatitis (AIH) has scarcely been reported on in patients of black African descent. Similarly, few studies have focused on the relationship between AIH and Human-Immunodeficiency Virus (HIV) infection.


We aim to describe the presenting features of AIH from a single referral centre in a Sub-Sahara African setting. We also compare the presenting features of HIV-infected and HIV-uninfected patients.


This study was a retrospective chart review. Patients were included if they fulfilled criteria for the International AIH Group simplified score for probable or definite AIH, were 18 years or older at inclusion, and attended the adult Gastroenterology clinic at Inkosi Albert Luthuli Central Hospital (IALCH) for the period 1/1/2015 to 31/12/2020 on at least 2 occasions.


Forty cases were included, of which 33 (82.5%) were female and 33 (82.5%) were black African. Median age at diagnosis was 26 years. A diagnosis of a coexistent autoimmune disease was made in 22.5% of patients, with Systemic Lupus Erythematosus (SLE) being the most common (12.5%). Sixteen patients were HIV-infected, all of whom were female (p =0.03), with a significantly older age of disease onset as compared to their HIV-uninfected counterparts (median age 38 vs 17.5 years, p <0.001).


AIH is a disease most commonly affecting young females. Female sex and older age of onset is associated with AIH in HIV-infected individuals.


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How to Cite

Maharaj Y, Naidoo VG. Diagnosis and presenting features of autoimmune hepatitis at a central referral hospital in South Africa. S Afr Med J [Internet]. 2024 Apr. 18 [cited 2024 Jun. 15];114(4). Available from: https://samajournals.co.za/index.php/samj/article/view/1646

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