Follow-up Study Of Re-evaluation Liver Biopsy After Treatment In Autoimmune Hepatitis Patients

Aims : Autoimmune hepatitis(AIH)is an organ-specific,autoimmune disease,and the maintenance of biochemical remission(including normal levels of serum transaminases and Ig G)is the desired end point of treatment for AIH patients.However,the intrahepatic histology of patients with biochemical remission is still controversial.This study aims to investigate the subsequent histological reassessment of patients who have achieved biochemical remission criteria and the characteristics of liver histology before and after treatment.Methods:This article retrospectively collected the clinical and histological data of 39 AIH patients with re-evaluation biopsy after standard treatment in our hospital from February 2010 to February 2018.Among them,twenty-five patients had diagnostic liver biopsy data.The pre-and post-treatment laboratory tests,the diagnostic liver biopsy,and the re-evaluation histology after treatment were analyzed.Results : Among 39 AIH patients enrolled,5 patients did not receive biochemical remission,while none of the 5 patients received histological remission.Among the 33 AIH patients with biochemical response at least24 months,17 patients(51.5%)achieved histological remission(G ? 1),but there were no significant differences in serum transaminases,Ig G and other serological parameters between the two groups.In diagnostic liver biopsy,hepatic inflammation was mild in histological remission patients(G: 2 vs.3,p = 0.035).There was no progression in the degree of fibrosis between the diagnostic and re-evaluation biopsy of histological remission patients.In the persisting histological activity group,18.2% of patients showed progression of fibrosis.Conclusions : In patients without biochemical remission,there was persistent inflammation in histology,and in patients with biochemical remission at least 24 months,nearly half of the patients did not achieve histological remission.Patients with less severe inflammation at the time of diagnosis of AIH are more likely to achieve histological remission.