Type I autoimmune hepatitis: clinical course and outcome in an Italian multicentre study
Article first published online: 12 SEP 2006
Alimentary Pharmacology & Therapeutics
Volume 24, Issue 7, pages 1051–1057, October 2006
How to Cite
FLOREANI, A., NIRO, G., ROSA RIZZOTTO, E., ANTONIAZZI, S., FERRARA, F., CARDERI, I., BALDO, V., PREMOLI, A., OLIVERO, F., MORELLO, E. and DURAZZO, M. (2006), Type I autoimmune hepatitis: clinical course and outcome in an Italian multicentre study. Alimentary Pharmacology & Therapeutics, 24: 1051–1057. doi: 10.1111/j.1365-2036.2006.03104.x
- Issue published online: 12 SEP 2006
- Article first published online: 12 SEP 2006
- Publication data Submitted 16 June 2006 First decision 16 July 2006 Resubmitted 25 July 2006 Accepted 28 July 2006
Background Many reports of autoimmune hepatitis (AIH) were written in the ‘pre-Hepatitis C era’ and data on the natural history are still incomplete.
Aim To evaluate the clinical presentation and the natural history of type I AIH.
Methods Seventy-three consecutive patients with a regular follow-up of at least 2 years were prospectively included in the study. The mean follow-up was 91 ± 61 months.
Results Patients with ‘acute’ onset at presentation were significantly older than patients with ‘chronic’ onset (P < 0.05) and had significantly higher serum levels of transaminase, γ-glutamyltransferase and bilirubin; Prothrombin time was significantly lower in the said group compared with AIH patients with ‘chronic’ onset. In 4 of 63 (6.3%) female patients, AIH had the onset during pregnancy; in all of them the outcome of pregnancy was favourable. The major events during the follow-up included oesophageal varices (n = 9) and ascites (n = 4), and 60 patients remained in remission while receiving immunosuppression. None of the patients died during the follow-up, but seven patients were transplanted. The cumulative transplant-free probability of survival was 73.5% at 280 months.
Conclusions Elderly patients have more frequently an acute onset at presentation. Survival in AIH is apparently good; with early diagnosis, and improved medical therapy, liver transplantation for AIH will become a rare event in future.