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Histological improvement of liver fibrosis in well-treated patients with autoimmune hepatitis: A cohort study
Department of Public Health and Clinical Medicine, Umeå University, Norrlands Universitetssjukhus, Umeå, Sweden.
Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden.
Department of Gastroenterology and Hepatology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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2017 (English)In: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 96, no 34, e7708Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2017. Vol. 96, no 34, e7708
Keyword [en]
autoimmune hepatitis, autoimmune liver disease, cirrhosis, fibrosis, inflammation
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-61042DOI: 10.1097/MD.0000000000007708ISI: 000408504800012PubMedID: 28834875Scopus ID: 2-s2.0-85028690293OAI: oai:DiVA.org:oru-61042DiVA: diva2:1142240
Note

Funding Agencies:

Albireo, Gothenburg, Sweden  

Intercept, San Diego, CA, USA  

Bengt Ihre's fund  

Västerbotten County, Umeå University Hospital 

Available from: 2017-09-19 Created: 2017-09-19 Last updated: 2017-09-19Bibliographically approved

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