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Autoimmune Hepatitis: Clinical Characteristics and Predictors of Biochemical Response to Treatment

BACKGROUND AND OBJECTIVES: Autoimmune hepatitis (AIH) is an important cause of chronic liver disease. Aim of this study was to evaluate the clinical characteristics and factors predicting response to treatment in patients with AIH. METHODS: In this prospective observational study, all patients diagn...

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Autores principales: Tasneem, Abbas Ali, Luck, Nasir Hassan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sciendo 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500116/
https://www.ncbi.nlm.nih.gov/pubmed/32983933
http://dx.doi.org/10.2478/jtim-2020-0016
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author Tasneem, Abbas Ali
Luck, Nasir Hassan
author_facet Tasneem, Abbas Ali
Luck, Nasir Hassan
author_sort Tasneem, Abbas Ali
collection PubMed
description BACKGROUND AND OBJECTIVES: Autoimmune hepatitis (AIH) is an important cause of chronic liver disease. Aim of this study was to evaluate the clinical characteristics and factors predicting response to treatment in patients with AIH. METHODS: In this prospective observational study, all patients diagnosed with AIH from 2017 to 2019 were included. Biochemical response to the treatment was checked three months after the start of the treatment. Response was considered good if transaminases normalized, or poor if either remained persistently elevated or improved partially. RESULTS: Of the total 56 patients, 41 (73.2%) were females. Mean age was 29.5 (±16.9) years. About half (53.6%; n = 30) the patients were aged < 25 years and majority [47 (83.9%)] were cirrhotic. Autoimmune serology was negative in 20 (35.7%). Seronegativity was associated with severe necroinflammation (P = 0.015) and esophageal varices (P = 0.021). Response to treatment was good in 34 (60.7%). Bivariate analysis showed that good response to treatment was associated with pre-treatment serum IgG level > 20 g/L (P = 0.024), presence of pseudorosettes on histopathology (P = 0.029) and three months post-immunosuppression serum total bilirubin < 2mg/dL (P < 0.001). Multivariate logistic regression analysis showed that only pre-treatment serum IgG >20 g/L (P = 0.038) and post-treatment serum total bilirubin <2 mg/dL (P = 0.004) were independent predictors of good response to treatment. CONCLUSION: Majority of AIH patients in our study were young and cirrhotic. A negative autoimmune serology does not rule out AIH and liver biopsy may be required to confirm the diagnosis. Seronegative AIH rapidly progresses to advanced liver disease. Response to treatment is good with pre-treatment IgG > 20g/L and post-treatment total bilirubin < 2 mg/dL.
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spelling pubmed-75001162020-09-25 Autoimmune Hepatitis: Clinical Characteristics and Predictors of Biochemical Response to Treatment Tasneem, Abbas Ali Luck, Nasir Hassan J Transl Int Med Original Article BACKGROUND AND OBJECTIVES: Autoimmune hepatitis (AIH) is an important cause of chronic liver disease. Aim of this study was to evaluate the clinical characteristics and factors predicting response to treatment in patients with AIH. METHODS: In this prospective observational study, all patients diagnosed with AIH from 2017 to 2019 were included. Biochemical response to the treatment was checked three months after the start of the treatment. Response was considered good if transaminases normalized, or poor if either remained persistently elevated or improved partially. RESULTS: Of the total 56 patients, 41 (73.2%) were females. Mean age was 29.5 (±16.9) years. About half (53.6%; n = 30) the patients were aged < 25 years and majority [47 (83.9%)] were cirrhotic. Autoimmune serology was negative in 20 (35.7%). Seronegativity was associated with severe necroinflammation (P = 0.015) and esophageal varices (P = 0.021). Response to treatment was good in 34 (60.7%). Bivariate analysis showed that good response to treatment was associated with pre-treatment serum IgG level > 20 g/L (P = 0.024), presence of pseudorosettes on histopathology (P = 0.029) and three months post-immunosuppression serum total bilirubin < 2mg/dL (P < 0.001). Multivariate logistic regression analysis showed that only pre-treatment serum IgG >20 g/L (P = 0.038) and post-treatment serum total bilirubin <2 mg/dL (P = 0.004) were independent predictors of good response to treatment. CONCLUSION: Majority of AIH patients in our study were young and cirrhotic. A negative autoimmune serology does not rule out AIH and liver biopsy may be required to confirm the diagnosis. Seronegative AIH rapidly progresses to advanced liver disease. Response to treatment is good with pre-treatment IgG > 20g/L and post-treatment total bilirubin < 2 mg/dL. Sciendo 2020-06-30 /pmc/articles/PMC7500116/ /pubmed/32983933 http://dx.doi.org/10.2478/jtim-2020-0016 Text en © 2020 Abbas Ali Tasneem et al., published by Sciendo http://creativecommons.org/licenses/by-nc-nd/4.0 This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
spellingShingle Original Article
Tasneem, Abbas Ali
Luck, Nasir Hassan
Autoimmune Hepatitis: Clinical Characteristics and Predictors of Biochemical Response to Treatment
title Autoimmune Hepatitis: Clinical Characteristics and Predictors of Biochemical Response to Treatment
title_full Autoimmune Hepatitis: Clinical Characteristics and Predictors of Biochemical Response to Treatment
title_fullStr Autoimmune Hepatitis: Clinical Characteristics and Predictors of Biochemical Response to Treatment
title_full_unstemmed Autoimmune Hepatitis: Clinical Characteristics and Predictors of Biochemical Response to Treatment
title_short Autoimmune Hepatitis: Clinical Characteristics and Predictors of Biochemical Response to Treatment
title_sort autoimmune hepatitis: clinical characteristics and predictors of biochemical response to treatment
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500116/
https://www.ncbi.nlm.nih.gov/pubmed/32983933
http://dx.doi.org/10.2478/jtim-2020-0016
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