title: Predictive factors of poor response to therapy in Autoimmune Hepatitis.
abstract: OBJECTIVE
  To evaluate "ex ante" the predictive factors of incomplete/absent response to the standard therapy in a well characterized series of Autoimmune Hepatitis (AIH) patients from Italy.
  
  
  METHODS
  Of 282 AIH patients screened from our database 166 (59%) had a sustained response and 116 (41%) had an incomplete/absent response to the therapy; all patients were analyzed for the clinical, serological and histological parameters at diagnosis.
  
  
  RESULTS
  The patients with incomplete/absent response were characterized by significantly younger age (30 aa vs 42 aa p=0.001) and a significantly higher frequency of cirrhosis at diagnosis than patients who had a complete response to therapy (26% vs 3% p<0.0001); furthermore, patients with incomplete/absent response were distinguished from those with a complete response for significantly lower serum levels of both AST (7.9×upper normal limit [unl] vs 13×unl p<0.005) and ALT (10.9×unl vs 18×unl p=0.002) at diagnosis, and by an increase in IgG serum levels (1.43×unl vs 1.27×unl p=0.009). After stepwise logistic regression, cirrhosis at diagnosis (p=0.003, OR 0.12, 95% CI 0.03-0.49) and younger age (p=0.001, OR 1.03, 95% CI 1.01-1.05) represent two independent variables of incomplete/absent response.
  
  
  CONCLUSIONS
  Younger age and cirrhosis are predictive of lack of response to the standard therapy in AIH patients.
authors.affiliation: Centre for the study and therapy of Autoimmune liver Disease, Bologna, Italy; Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum - Università di Bologna, Italy. Electronic address: paolo.muratori3@unibo.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Muratori
authors.affiliation: Centre for the study and therapy of Autoimmune liver Disease, Bologna, Italy; Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum - Università di Bologna, Italy. Electronic address: claulal@unib.it.
authors.forename: Claudine
authors.initials: C
authors.lastname: Lalanne
authors.affiliation: Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum - Università di Bologna, Italy. Electronic address: gippob@unib.it.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Bianchi
authors.affiliation: Centre for the study and therapy of Autoimmune liver Disease, Bologna, Italy; Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum - Università di Bologna, Italy. Electronic address: marklenz@unib.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Lenzi
authors.affiliation: Centre for the study and therapy of Autoimmune liver Disease, Bologna, Italy; Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum - Università di Bologna, Italy. Electronic address: luimura@unib.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Muratori
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001379:Azathioprine / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D004351:Drug Resistance; D005260:Female; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007558:Italy; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008111:Liver Function Tests; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001379:Azathioprine
keywords: Autoimmune liver disease; Cirrhosis; Immunology; Liver function tests