Type I autoimmune hepatitis: clinical course and outcome in an Italian multicentre study.
BACKGROUND
Many reports of autoimmune hepatitis (AIH) were written in the 'pre-Hepatitis C era' and data on the natural history are still incomplete.


OBJECTIVE
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, gamma-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.
Floreani
A
A
Department of Surgical and Gastroenterological Sciences, University of Padova, Padova, Italy. annarosa.floreani@unipd.it
Niro
G
G
Rosa Rizzotto
E
E
Antoniazzi
S
S
Ferrara
F
F
Carderi
I
I
Baldo
V
V
Premoli
A
A
Olivero
F
F
Morello
E
E
Durazzo
M
M
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D005260:Female; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D015415:Biomarkers