Autoimmune hepatitis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: :Manpreet Kaur, MD [2]

Overview

The symptoms of Autoimmune hepatitis usually has a bimodal age distribution, with a first peak of incidence at age 10-20 years and a second at age 45-70 years of life, and starts with asymptomatic progresses to acute liver failure.^[1]
If left untreated, patients with Autoimmune hepatitis may progress to develop Cirrhosis, and Portal hypertension.

Common complications of Autoimmune hepatitis include:^[2]^[3]

Prognosis is generally excellent, and the 10-year survival rate of patients with Autoimmune hepatitis treated with immunosuppressive therapy is approximately 80%.^[4]^[5]
Prognosis is bad without treatment, 50% of patients with severe autoimmune hepatitis will die in a 5 years, and 80-90% of patients will die within 10 years of disease onset.
The presence of young age at presentation, AIH-2, coagulopathy, severe histologic activity is associated with a poor prognosis among patients with Autoimmune hepatitis.

↑ Sonthalia N, Rathi PM, Jain SS, Surude RG, Mohite AR, Pawar SV, Contractor Q (2017). "Natural History and Treatment Outcomes of Severe Autoimmune Hepatitis". J. Clin. Gastroenterol. 51 (6): 548–556. doi:10.1097/MCG.0000000000000805. PMID 28272079.
↑ Trivedi PJ, Hirschfield GM (2013). "Treatment of autoimmune liver disease: current and future therapeutic options". Ther Adv Chronic Dis. 4 (3): 119–41. doi:10.1177/2040622313478646. PMC 3629750. PMID 23634279.
↑ Gleeson D, Heneghan MA (2011). "British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis". Gut. 60 (12): 1611–29. doi:10.1136/gut.2010.235259. PMID 21757447.
↑ Hoeroldt B, McFarlane E, Dube A, Basumani P, Karajeh M, Campbell MJ, Gleeson D (2011). "Long-term outcomes of patients with autoimmune hepatitis managed at a nontransplant center". Gastroenterology. 140 (7): 1980–9. doi:10.1053/j.gastro.2011.02.065. PMID 21396370.
↑ D'Amico G, Garcia-Tsao G, Pagliaro L (2006). "Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies". J. Hepatol. 44 (1): 217–31. doi:10.1016/j.jhep.2005.10.013. PMID 16298014.