title: [Histological regression of liver fibrosis with immunosuppressive therapy in autoimmune hepatitis].
abstract: Reversibility of liver fibrosis with immunosuppressive therapy (IT) has been described in autoimmune hepatitis (AIH).
  
  
  OBJECTIVE
  To compare initial fibrosis and fibrosis after IT in patients with AIH.
  
  
  METHODS
  A total of 54 patients were admitted with positive ANA or AML antibodies, or both, elevated IgG immunoglobulins and who met international criteria for a diagnosis of AIH. The mean age was 39 years (range 13-65) and there were 47 women (87%). Two liver biopsies were taken: one at diagnosis and another at a mean of 28±8 months after initiation of IT with prednisone and azathioprine. The degree of inflammation (0-18) and fibrosis (0-6) according to Ishak score was compared between the initial and the follow-up biopsy.
  
  
  RESULTS
  Fibrosis decreased from 2.9±0.3 to 2.2±0.3 (p=0.005) and histological activity index from 6.8±0.45 to 2.6±0.2 (P<.001). In subgroups, fibrosis decreased from 3.6±0.4 to 1.4±0.3 (P<.001) in 22 patients (41%), was unchanged in 27 (50%) and increased in five (9%). There were seven patients with histological cirrhosis at IT initiation. After IT, four showed a reduction in Ishak score (achieving scores of 0-3). Transaminase values were not associated with histological improvement.
  
  
  CONCLUSIONS
  Fibrosis in patients with AIH significantly improved with IT, emphasizing the importance of studying the prognostic factors associated with this favorable response.
authors.affiliation: Sección de Gastroenterología, Hospital San Juan de La Serena y Universidad Católica del Norte, Coquimbo, Chile.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Valera
authors.forename: Gladys
authors.initials: G
authors.lastname: Smok
authors.forename: Sylvia
authors.initials: S
authors.lastname: Márquez
authors.forename: Jaime
authors.initials: J
authors.lastname: Poniachik
authors.forename: Javier
authors.initials: J
authors.lastname: Brahm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use*; D005260:Female; D019693:Hepatitis, Autoimmune / Q000150:complications*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D011446:Prospective Studies; D012074:Remission Induction; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine; D011241:Prednisone