Prediction of the course of autoimmune hepatitis and primary biliary cirrhosis

North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia

A retrospective analysis of medical records, a complex examination and a 3-year prospective observation of 171 patients with autoimmune liver disease, including 62 — with autoimmune hepatitis (AIH), 64 — with primary biliary cirrhosis (PBC) and 45 — with primary biliary cirrhosis with features of autoimmune hepatitis (AIH/PBC) were performed. Multivariate logistic regression analysis was used to determine predictors of diseases course. Database included 111 clinical, laboratory and histological parameters for AIH and 108 — for PBC.

The age of disease onset, stage of fibrosis by METAVIR and response to standard treatment (remission) (odds ratio (95 % confidence interval) — 0.84 (0.46-1.54) 14.29 (2,78-100,0), 0.36 (0.05-2.78), respectively) were independent predictors of high-progressive course of AIH. The stage of fibrosis (estimated by METAVIR), itching at the onset disease, response to therapy (clinical and biochemical improvement), features of AIH (odds ratio (95 % confidence interval) — 0.62 (0.06-0.78), 0.35 (0.20-0.63), 5.45 (1.49-20.02), 0.49 (0.15-1.58) for slow-progressive course, respectively) were independent predictors of high / slow-progressive course of PBC. The prognostic models of the diseases course were created based on these data.

Key words: autoimmune hepatitis, overlap syndrome, primary biliary cirrhosis, prognosis, predictor, course of the diseases.

Contact: K.L. Raikhelson Tel. +7-911-911-01-43 e-mail: kraihelson@mail.ru