Clinical, biochemical and histological features related to treatment response and prognosis in autoimmune hepatitis

Clinical, biochemical and histological features related to treatment response and prognosis in autoimmune hepatitis

Autoimmune hepatitis (AIH) is a rare disease with a complex and not fully understood pathogenesis. Prognostic factors that might influence treatment response, relapse rates, and transplant-free survival are not well established. This study investigates clinical and biochemical markers associated wit...

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Bibliographic Details
Published in:Annals of hepatology Vol. 29; no. 4; p. 101497
Main Authors: Guedes, Ludmila Resende, Cançado, Guilherme Grossi Lopes, Santos, Bruno Campos, Jacomassi, Luma dos Santos, Nardelli, Mateus Jorge, Osório, Fernanda Maria Farage, Faria, Luciana Costa, Couto, Cláudia Alves
Format: Journal Article
Language:English
Published: Mexico Elsevier España, S.L.U 01-07-2024
Elsevier
Subjects:
Autoimmune hepatitis
Brazil
Cirrhosis
Latin America
Liver transplant
Prognostic factors
AIH
Cirrhosis
AST
Autoimmune hepatitis
MELD
Liver transplant
Brazil
ALT
FIB-4
Prognostic factors
Latin America
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Summary:Autoimmune hepatitis (AIH) is a rare disease with a complex and not fully understood pathogenesis. Prognostic factors that might influence treatment response, relapse rates, and transplant-free survival are not well established. This study investigates clinical and biochemical markers associated with response to immunosuppression in patients with AIH. This retrospective cohort study included 102 patients with AIH treated with immunosuppressants and followed at the Federal University of Minas Gerais, Brazil, from 1990 to 2018. Pretreatment data such as clinical profiles, laboratory, and histological exams were analyzed regarding biochemical response at one year, histological remission, relapse, and death/transplantation rates. Cirrhosis was present in 59 % of cases at diagnosis. One-year biochemical remission was observed in 55.7 % of the patients and was found to be a protective factor for liver transplant. Overall survival was 89 %. Patients with ascites at disease onset showed a higher aspartate aminotransferase (AST)/ alanine aminotransferase (ALT) ratio and elevated Model of end-stage liver disease (MELD) score. The presence of ascites was significantly associated with a 20-fold increase in mortality rate. AIH has a severe clinical phenotype in Brazilians, with high rates of cirrhosis and low remission rates. Early diagnosis and treatment are essential for achieving remission and reducing complications. The presence of ascites is significantly associated with mortality, emphasizing the importance of monitoring and prompt intervention. This study also stresses the need for further research on AIH in Latin America.
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ISSN:1665-2681
2659-5982
DOI:10.1016/j.aohep.2024.101497