Reversibility of hepatic fibrosis in autoimmune hepatitis

Ann Intern Med. 1997 Dec 1;127(11):981-5. doi: 10.7326/0003-4819-127-11-199712010-00006.


Background: Hepatic fibrosis and cirrhosis occur in many types of chronic liver injury and generally seem to be irreversible.

Objective: To determine whether cirrhosis caused by autoimmune hepatitis can be reversible.

Design: Retrospective study.

Patients: Eight patients with autoimmune hepatitis and cirrhosis who responded to medical therapy and had follow-up liver biopsy while in clinical and biochemical remission.

Measurements: Biopsy specimens were randomly coded in an unpaired manner according to patient and were read independently by two pathologists using the Knodell scoring system.

Results: The median alanine aminotransferase level decreased from 10.30 mukat/L to 0.37 mukat/L, the median serum bilirubin level decreased from 70 mumol/L to 10 mumol/L, and the median serum albumin level increased from 34 g/L to 43 g/L. Cirrhosis, extensive fibrosis, or both were present in all patients at diagnosis but were not present on follow-up liver biopsy. The median Knodell score decreased from 14.0 to 1.3, and the median fibrosis score decreased from 3.3 to 0.8.

Conclusion: Hepatic fibrosis and cirrhosis may be reversible in some patients in whom autoimmune hepatitis responds to treatment.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Biopsy
  • Child
  • Drug Therapy, Combination
  • Female
  • Glucocorticoids / therapeutic use
  • Hepatitis, Autoimmune / complications*
  • Hepatitis, Autoimmune / pathology
  • Humans
  • Immunosuppressive Agents
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / physiopathology
  • Liver Function Tests
  • Male
  • Middle Aged
  • Remission Induction
  • Retrospective Studies


  • Glucocorticoids
  • Immunosuppressive Agents