In a recent paper published in the Hepatology journal entitled “Prediction of short-and long-term outcome in patients with autoimmune hepatitis“, researchers found it is possible to predict the outcomes of patients with autoimmune hepatitis by looking at cirrhosis and antibodies.
Autoimmune hepatitis is a chronic autoimmune disease in which the body’s immune system attacks liver cells leading to inflammation. Patients with AIH may experience a variety of symptoms including signs of liver inflammation including fever, yellowish pigmentation of the skin, pain in the upper part of the abdomen and fatigue. Though AIH disease may affect any ethnic group of any age, it is often diagnosed in patients of 40 to 50 years with female predominance. The disease may be caused by a variety of factors such as chronic hepatitis. With respect to therapy, AIH is generally treated by various medications that, depending on patients, may or may not work.
Liver transplantation represents the best therapeutic option especially when patients do not respond to medications or for those with end-stage liver disease. The study carried out by a team of German scientists aimed to elucidate clinical, serological, and genetic features that could have an impact in remission/relapse rates of AIH disease in patients with liver transplantation.
In this study, a total of 354 AIH patients’ clinical, laboratory, and histological reports were evaluated. Genetic analysis of a protein called DRB1 was performed in 264 AIH and 399 non-AIH patients. A statistical method that explores the relationship between the survival of a patient and several explanatory variables was followed to identify factors associated with survival.
The results showed that patients diagnosed during childhood had a higher risk of disease recurrences (relapses) as well as reduced life expectancy. The presence of species involved in the immune response (called liver antigen/liver pancreas antigen antibodies, SLA/LP) was linked to a reduced liver transplantation-free survival. Furthermore, cirrhosis, a liver dysfunction due to long-term damage, was recorded as a predictor of poor survival and associated with liver transplantation. The factor responsible for a higher rate of complete remissions and lower frequency of cirrhosis and liver transplantation was found to be DRB1.
The authors concluded that due to the higher risks presented by AIH patients diagnosed during childhood, especially those with cirrhosis or SLA/LP, there is a need for elevated medical surveillance. As such, screening for cirrhosis, SLA/LP and DRB1 should be implemented during clinical diagnosis of AIH.