title: Clinical features and long term outcome of 102 treated autoimmune hepatitis patients.
abstract: BACKGROUND
  There is limited data on the natural history of autoimmune hepatitis (AIH) and on the long-term follow-up of AIH patients who have been referred for regular medical attention.
  
  
  OBJECTIVE
  We evaluated the clinical presentation and natural history of AIH in a large cohort of type I AIH patients from Iran.
  
  
  METHODS
  Between 1997 and 2008, 102 patients were enrolled in the study. Patients were diagnosed using the International Autoimmune Hepatitis Group criteria and were followed up for an average of 60 months. Clinical and biochemical data were gathered from all the patients at both the beginning and the end of the follow-up period. Liver biopsy was performed in all patients before treatment, and the biopsies were performed in 28 patients after treatment.
  
  
  RESULTS
  Biochemical remission was achieved by 80 (79.4%) patients. Of these, 53 (66.5%) showed near-normal liver histology or liver function test results and sonogram. The remaining 27 (33.5%) patients also achieved clinical and biochemical remission, but developed compensated cirrhosis. After a period of remission, 24 patients (32.5%) relapsed. Among the 22 (21.6%) patients who showed ultimate treatment failure, 6 underwent orthotopic liver transplantation and 3 died of liver failure while awaiting a transplant. Sixteen (72.7%) of the 22 patients who did not respond to therapy were non-compliant with medications and had irregular follow-up. The overall 10-year survival rate in the cohort was 96%.
  
  
  CONCLUSIONS
  Long-term survival in AIH patients is very good. Prompt diagnosis and appropriate first-line and salvage therapy that includes close follow-up will make liver transplantation a rare necessity in the treatment of this disease.
authors.affiliation: Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Zinab
authors.initials: Z
authors.lastname: Malekzadeh
authors.forename: Sepideh
authors.initials: S
authors.lastname: Haghazali
authors.forename: Sadaf G
authors.initials: SG
authors.lastname: Sepanlou
authors.forename: Homayoon
authors.initials: H
authors.lastname: Vahedi
authors.forename: Shahin
authors.initials: S
authors.lastname: Merat
authors.forename: Masoud
authors.initials: M
authors.lastname: Sotoudeh
authors.forename: Siavosh
authors.initials: S
authors.lastname: Nasseri-Moghaddam
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh