Persistent elevation of serum alanine aminotransferase levels leads to poor survival and hepatocellular carcinoma development in type 1 autoimmune hepatitis
Article first published online: 20 SEP 2006
Alimentary Pharmacology & Therapeutics
Volume 24, Issue 8, pages 1197–1205, October 2006
How to Cite
MIYAKE, Y., IWASAKI, Y., TERADA, R., OKAMAOTO, R., IKEDA, H., MAKINO, Y., KOBASHI, H., TAKAGUCHI, K., SAKAGUCHI, K. and SHIRATORI, Y. (2006), Persistent elevation of serum alanine aminotransferase levels leads to poor survival and hepatocellular carcinoma development in type 1 autoimmune hepatitis. Alimentary Pharmacology & Therapeutics, 24: 1197–1205. doi: 10.1111/j.1365-2036.2006.03113.x
- Issue published online: 20 SEP 2006
- Article first published online: 20 SEP 2006
- Publication data Submitted 30 May 2006 First decision 5 July 2006 Resubmitted 15 July 2006 Accepted 7 August 2006
Although the prognosis of type 1 autoimmune hepatitis is generally good with immunosuppressive treatment, the disease progresses in some patients despite the treatment. The prognosis may be determined by the clinical course.
To evaluate the long-term prognosis and assess the predictive factors for a serious event, including the development of hepatocellular carcinoma or death.
Sixty-nine patients with type 1 autoimmune hepatitis were prospectively followed up regularly, with a median follow-up period of 96 months (49–201 months).
During the follow-up period, three patients (4%) developed hepatocellular carcinoma, and two of these three patients died. Another patient died of liver failure. The 10-year survival rate was 98%, and the 10-year hepatocellular carcinoma-free rate was 93%. The four patients experiencing a serious event received higher maintenance doses of corticosteroid during their follow-up periods than those did not. However, serum alanine aminotransferase levels during the follow-up period were higher in these four patients than in the others.
Persistent elevation of serum alanine amniotransferase levels during the follow-up period, rather than factors existing prior to medical treatment is considered to be an important prognostic factor, and it is indicated that poor outcomes may result from the resistance to immunosuppressive treatment.