Gerussi, A;
Halliday, N;
Saffioti, F;
Bernasconi, DP;
Roccarina, D;
Marshall, A;
Thorburn, D;
(2020)
Normalization of serum immunoglobulin G levels is associated with improved transplant-free survival in patients with autoimmune hepatitis.
Digestive and Liver Disease
, 52
(7)
pp. 761-767.
10.1016/j.dld.2020.04.012.
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Abstract
BACKGROUND: There is limited evidence linking achievement of biochemical response with outcomes in Autoimmune Hepatitis (AIH), and it is unclear whether normalization of serum immunoglobulin G (IgG) levels influences prognosis. AIMS: We aimed to investigate factors associated with death or liver transplantation in patients affected by AIH. METHODS: We undertook a retrospective analysis of all AIH patients attending a tertiary liver unit since 1980. Patients not meeting established diagnostic criteria for AIH or with a follow-up shorter than 18 months were excluded. RESULTS: 107 patients meeting inclusion criteria were included in the study. Mean age at diagnosis was 44 years, 29 patients (27.1%) had cirrhosis at baseline. Median follow-up was 79 months, and 70 patients (79.5%) reached biochemical response. Biochemical response was associated with reduced hazard of liver transplant or death (HR 0.07, 95% CI 0.01-0.46), whereas cirrhosis at diagnosis was an independent predictor of liver transplantation or death (Hazard ratio (HR) 11.8, 95%, confidence interval (CI) 1.18-117.4). Lack of normalization of serum IgG levels was associated with reduced 5-year transplant-free survival (95% in patients normalizing, compared to 86%, p = 0.02). CONCLUSION: Normalization of serum IgG levels alone translates in better transplant-free survival in patients with AIH and should be a treatment target along with transaminases.
| Type: | Article |
|---|---|
| Title: | Normalization of serum immunoglobulin G levels is associated with improved transplant-free survival in patients with autoimmune hepatitis |
| Location: | Netherlands |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.dld.2020.04.012 |
| Publisher version: | https://doi.org/10.1016/j.dld.2020.04.012 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Autoimmune liver disease, Liver cirrhosis, Liver immunology, Risk stratification |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10105761 |
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