Liver Dysfunction And Fibrosis As Predictors Of Biochemical Response To Autoimmune Hepatitis Treatment

BACKGROUND: Autoimmune hepatitis (AIH) is a disease that presents itself in various forms, ranging from aminotransferase asymptomatic alteration, acute hepatitis to decompensated cirrhosis. Few studies have evaluated the predictive criteria as a response to treatment.METHODS: A cross-sectional analytical study examined patients with AM who were visited in the hepatology clinic of a university hospital between January 2013 and July 2015:RESULTS: A total of 36 patients were included (44.7 +/- 14.3 years, 22.2% male, and 19.2% of patients presented with liver failure). Patients with significant fibrosis had lower mean aminotransferases and bilirubins and higher mean prothrombin activity (PA) than those with insignificant fibrosis. Most patients (94.5%) underwent treatment with azathioprine and prednisone. In a comparison between individuals who exhibited biochemical response (ALT and AST <55 U/L in the sixth month of treatment) and those without biochemical response, it was observed that those with biochemical response presented minor proportion of patients with significant fibrosis, and these patients had a higher proportion of liver failure in initial presentation and lower mean PA. Furthermore, it was observed that the lower the PT on admission was, the lower ALT levels (r=0.682, P=0.020) and AST (r=0.431. P=0.040) in the sixth month of treatment were.CONCLUSIONS: Individuals with liver dysfunction and elevated aminotransferases show insignificant fibrosis histologically. AIII patients who initially present liver failure and insignificant fibrosis are more likely to develop biochemical response to treatment.