Autoimmune hepatitis (AIH) is a lifelong disease, and progressive immune-mediated liver disease that can progress to cirrhosis, and liver transplantation, which requires continuous treatment and care in most patients. Evaluation of liver fibrosis at baseline and monitoring of the disease progression under treatment would greatly improve patient care.
AIH was diagnosed on clinical, biochemical, serological and histopathological findings and conformed to the recent European Association for the Study of the Liver (EASL) guideline. All patients underwent a liver biopsy and chronic viral hepatitis B and C had been excluded by serological testing in all patients. Exclusion criteria were drug-induced liver disease, alcoholic or non-alcoholic fatty liver disease, metabolic liver disease, hepatobiliary parasitic infection and decompensated liver disease (characterized by ascites, hepatic encephalopathy, gastrointestinal bleeding, and/or hepatocellular carcinoma). Drug- and alcohol-induced hepatitis had been excluded by medical history and histological examination. The study was approved by the Ethics Committee of Mashad University of Medical Sciences. Fibroscan was done after 6 months of diagnosis and treatment to reduce pseudo fibrosis.
Patient characteristics: 71 patients with autoimmune hepatic disorder were included. Of those, 49 subjects had pure AIH and 22 had overlap of AIH with primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC). The mean age of patients was 43. and 56 individuals (79%) were female. The mean BMI was 25.9 and mean steatosis was 27.87%. Evaluation by fibroscan of patients at baseline revealed that 20 (28.2%) had F4 and 19 (26.8%) had F2 and only 15.5% of patients had F0-F1. The mean of LSM was 11.8 kpa and median was 16.84 KPS with standard deviation of 3.14.
As indicated by our results, 28.2% of the patients had severe fibrosis at baseline. Baseline characteristic and LS of patients with AIH which id detected by fibroscan can help to predict their outcome and find out how rigorously should observe under treatment.
