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Observational Study
, 96 (34), e7708

Histological Improvement of Liver Fibrosis in Well-Treated Patients With Autoimmune Hepatitis: A Cohort Study

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Observational Study

Histological Improvement of Liver Fibrosis in Well-Treated Patients With Autoimmune Hepatitis: A Cohort Study

Åsa D Borssén et al. Medicine (Baltimore).

Abstract

Autoimmune hepatitis (AIH) is a chronic autoimmune liver disease that if left untreated may lead to the development of cirrhosis. Previous studies on AIH patients have suggested that fibrosis and even cirrhosis can be reversed by medical treatment. The aim of this study was to evaluate the efficacy of medical treatment for protection of developing fibrosis and cirrhosis.A total of 258 liver biopsies from 101 patients (72 women, 29 men) were analyzed by a single pathologist and classified according to the Ishak grading (inflammation) and staging (fibrosis) system. Liver histology was stratified according to the temporal changes of fibrosis stage (increased, decreased, or stable), and groups were compared.Complete or partial response to medical treatment was 94.9%. Reduction of fibrosis stage from the first to the last biopsy was seen in 63 patients (62.4%). We found an association between a reduction in the fibrosis stage and continuous glucocorticoid medication, as well as lowered scores of inflammation at last biopsy. Twenty-one patients had cirrhosis (Ishak stage 6) at least in one of the previous biopsies, but only 5 patients at the last biopsy.Histological improvement is common in AIH patients that respond to medical treatment, and a reduction or stabilization of fibrosis stage occurs in about 2/3 of such patients.

Conflict of interest statement

The remaining authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow chart of the inclusion of biopsies.
Figure 2
Figure 2
Fibrosis stage in 258 biopsies from 101 AIH patients, sorted by year after diagnosis. AIH = autoimmune hepatitis.

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