Clinical Features and Long Term outcome of 102 Treated Autoimmune Hepatitis Patients

Background: data on the natural history and long term follow up of patients with autoimmune hepatitis who refer for regular medical attention is limited.objectives: we aimed to evaluate the clinical presentation and the natural history of a large cohort of type i aih from iran.materials and methods: between 1997 and 2008, 102 patients were included in the study. patients were diagnosed using the international autoimmune hepatitis group criteria and were followed up for an average of 60 months. clinical and biochemical data were gathered from all patients at both the beginning and end of follow-up. liver biopsy was done for all of the patients before, and for 28 patients after treatment.results: biochemical remission was achieved in 80 (79.4%) cases among whom, 53 (66.5%) attained cure with almost normal liver histology and/or liver function test and sonography. the remaining 27 (33.5%) patients also achieved clinical and biochemical remission, but developed compensated cirrhosis as well. relapse was seen in 24 patients (32.5%) after remission. from 22 (21.6%) subjects with ultimate treatment failure, 6 underwent orthotopic liver transplantation and 3 died from liver failure while in transplant list. sixteen 16 (72.7%) of 22 patients who did not respond to therapy were non-compliant with medications and had irregular follow up. ten year survival for all cohort was 96%.conclusions: long term survival in aih patients is very good. prompt diagnosis and appropriate first line and salvage therapy with close follow-up will make liver transplantation rarely necessary for treatment of this disease in future.