ORIGINAL ARTICLES   

Minerva Gastroenterologica e Dietologica 2016 June;62(2):138-47

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Liver dysfunction and fibrosis as predictors of biochemical response to autoimmune hepatitis treatment

Júlia C. SOARES ¹, Ariane BORGONOVO ¹, Dariana C. MAGGI ¹, Ana P. PASINATO ², Fernanda G. RAMOS ¹, Esther B. DANTAS-CORRÊA ¹, Leonardo L. SCHIAVON ¹, Janaína L. NARCISO-SCHIAVON ¹ ✉

¹ Division of Gastroenterology, Internal Medicine, Federal University of Santa Catarina, Florianópolis, Brazil; ² Pathology Service (SAP), Federal University of Santa Catarina, University Hospital Polydoro Ernani de São Thiago, Florianópolis, Brazil

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 AIH 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. AIH patients who initially present liver failure and insignificant fibrosis are more likely to develop biochemical response to treatment.