We Are Not Immune: Racial and Ethnic Disparities in Autoimmune Liver Diseases

Hepatology. 2021 Nov;74(5):2876-2887. doi: 10.1002/hep.31985. Epub 2021 Aug 10.

Abstract

Autoimmune liver diseases are attributed to a complex interplay of biologic, acquired, and environmental factors. Increased prevalence, later stage at presentation, worse response to standard therapy, and transplant-related disparities have all been reported in racial and ethnic minorities such as Black and Latinx patients with autoimmune liver diseases. While biology and inherited genetic predispositions may partly explain these disparities, definitive and universal genetic variations underlying these differences in outcomes have not been defined. Nonetheless, socioeconomic status, access to health care, environmental and societal factors, and implicit provider bias can all contribute to poor patient outcomes. There remains an unmet need to understand and mitigate the factors contributing to health inequity in autoimmune liver diseases. In this review, we summarize the data on racial and ethnic disparities in presentation, treatment response, and outcomes pertaining to autoimmune liver diseases in minority populations, on the premise that understanding disparities is the first step toward reaching health equity.

Publication types

  • Review

MeSH terms

  • Black People / statistics & numerical data
  • Black or African American
  • Cholangitis, Sclerosing / epidemiology*
  • Cholangitis, Sclerosing / immunology
  • Cholangitis, Sclerosing / therapy
  • Ethnic and Racial Minorities / statistics & numerical data*
  • Health Inequities*
  • Health Services Accessibility
  • Health Services Needs and Demand
  • Hepatitis, Autoimmune / epidemiology*
  • Hepatitis, Autoimmune / immunology
  • Hepatitis, Autoimmune / therapy
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Liver / immunology
  • Social Determinants of Health / statistics & numerical data
  • United States / epidemiology