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Histological improvement of liver fibrosis in well-treated patients with autoimmune hepatitis A cohort study
Umeå University, Sweden.
Umeå University, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Gastroentorology.
University of Gothenburg, Sweden.
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2017 (English)In: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 96, no 34, article id 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, article id e7708
Keywords [en]
autoimmune hepatitis; autoimmune liver disease; cirrhosis; fibrosis; inflammation
National Category
General Practice
Identifiers
URN: urn:nbn:se:liu:diva-140973DOI: 10.1097/MD.0000000000007708ISI: 000408504800012PubMedID: 28834875OAI: oai:DiVA.org:liu-140973DiVA, id: diva2:1142308
Note

Funding Agencies|Albireo, Gothenburg, Sweden; Intercept, San Diego, CA, USA; Bengt Ihres fund; Vasterbotten County, Umea University Hospital

Available from: 2017-09-19 Created: 2017-09-19 Last updated: 2018-01-13

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Kechagias, Stergios
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