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Background/Aims: Autoimmune hepatitis shows a good response to immunosuppressive treatment, and the prognosis may be determined by the clinical course. The present study was conducted in order to analyze the factors contributing to the outcomes of patients with type 1 autoimmune hepatitis. Methods: Eighty-four consecutive patients with type 1 autoimmune hepatitis were followed up regularly for a median follow-up period of 70.5 months (16.2-163 months). We analyzed the pr ognostic factors using time-fixed and time-dependent Cox proportional hazard m odels. The end point was progression of the disease to decompensated liver cirrh osis. Results: Seventy-seven patients (92%) were treated with prednisolone dur ing the follow-up period, and 11 patients (13%) developed decompensated liver cirrhosis. Using a time-dependent multivariate model, the starting dose of cort icosteroid (dose of prednisolone < 20 mg/day), relapse within 3 months after the normalization of serum alanine aminotransferase levels with initial treatment, and elevated serum alanine aminotransferase levels during the follow-up period ( > 40 IU/L), all showed a significant association with progression of the disea se. Conclusions: The prognosis of type 1 autoimmune hepatitis on adequate immuno suppressive treatment improves when the serum alanine aminotransferase level per sists at ≤40 IU/L. Factors existing prior to medical treatment may not affect t he prognosis.
Background / Aims: Autoimmune hepatitis shows a good response to immunosuppressive treatment, and the prognosis may be determined by the clinical course. The present study was conducted in order to analyze the factors contributing to the outcomes of patients with type 1 autoimmune hepatitis. Methods: Eighty-four consecutive patients with type 1 autoimmune hepatitis were followed up up regularly for a median follow-up period of 70.5 months (16.2-163 months). We analyzed the prognostic factors using time-fixed and time-dependent Cox proportional hazard m odels . The end point was progression of the disease to decompensated liver cirrhosis. Results: Seventy-seven patients (92%) were treated with prednisolone dur ing the follow-up period, and 11 patients (13%) developed decompensated liver cirrhosis. a time-dependent multivariate model, the starting dose of cort icosteroid (dose of prednisolone <20 mg / day), relapse within 3 months after the normalization of serum alanine aminotransferas e levels with initial treatment, and elevated serum alanine aminotransferase levels during the follow-up period (> 40 IU / L), all showed a significant association with progression of the disea se. Conclusions: The prognosis of type 1 autoimmune hepatitis on adequate immuno suppressive treatment improves when the serum alanine aminotransferase level per sists at ≤ 40 IU / L. Factors existing prior to medical treatment may not affect t he prognosis.