Young females with alcohol-associated hepatitis face a 47% higher risk of developing cirrhosis compared to their male counterparts, according to a recent study published in JAMA Network Open.

The study examined sex-specific differences in outcomes among adolescents and young adults (AYAs) aged 13 to 39 years. Using population-based health data from 3,340 participants in Ontario, Canada (2002–2021), researchers linked healthcare records to assess long-term liver-related outcomes such as cirrhosis, decompensation, and mortality.

Alcohol-associated hepatitis (AH) rates rose 8% annually, with females showing a steeper rise (rate ratio [RR], 1.11; 95% confidence interval [CI], 1.09-1.12) compared to males (RR, 1.07; 95% CI, 1.06-1.07). At the 10-year mark, liver-related mortality was significantly higher among females (11.0%; 95% CI, 8.3%-14.2%) than males (6.9%; 95% CI, 5.4%-8.6%; P = .01).

Among the 2,374 participants who survived their initial AH presentation, 22% (n=527) developed cirrhosis and/or decompensation during a median follow-up of four years. Females were disproportionately affected (37% vs. 29%; P < .001). Notably, the cumulative incidence of cirrhosis and/or decompensation at 5 years was higher in females (24.7%) than males (18.6%). Females with cirrhosis were also more likely to present with decompensation (47% vs. 38%; P < .001).

Risk factors for poor outcomes included older age, urban residence, and living in lower-income neighborhoods. Despite the observed disparities, 71% of AYAs survived their initial AH presentation without cirrhosis or decompensation.

Full disclosures can be found in the published study.