Factors predictive of treatment response and survival in Filipino patients with autoimmune hepatitis

MD Jessa Monalee Mampao-gentallan; MD Frederick T Dy; MD Carmelita D Dalupang; MD Rommel P Romano; MD Alvin Brian C Velasco; MD Stephen N Wong

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Factors predictive of treatment response and survival in Filipino patients with autoimmune hepatitis

Author: Jessa Monalee Mampao-Gentallan, MD ¹ ; Frederick T. Dy, MD ^{1
,

2} ; Carmelita D. Dalupang, MD ^{1
,

2} ; Rommel P. Romano, MD ^{1
,

2} ; Alvin Brian C. Velasco, MD ^{1
,

2} ; Stephen N. Wong, MD ^{1
,

2
,

3}
Author Information

1. Section of Gastroenterology, University of Santo Tomas Hospital, Sampaloc, Manila
2. Faculty of Medicine and Surgery, University of Santo Tomas
3. Section of Gastroenterology, Chinese General Hospital and Medical Center, Sta. Cruz, Manila
Publication Type:Journal Article
Keywords: Treatment response
MeSH: Autoimmune Hepatitis; Liver Cirrhosis; Steroids; Azathioprine
From: Philippine Journal of Internal Medicine 2023;61(1):11-18
CountryPhilippines
Language:English
Abstract: Background:There is a dearth of data on Filipino patients with autoimmune hepatitis (AIH). We aimed to describe the demographic and clinical profiles of patients with AIH and to characterize clinical outcomes and treatment responses.
Methods:A retrospective cohort study involving patients from two tertiary centers diagnosed with AIH from January 1, 2007, to December 31, 2019, was included. Disease remission was defined as the normalization of ALT levels, while failure was defined as an increase in ALT levels over baseline or clinical deterioration.
Results:A total of 48 patients were identified between 2007 to 2019. The median age at presentation was 51 (27-79 yrs.). Liver cirrhosis was already present in 37.5% (27.1% decompensated) on diagnosis. Aside from a higher histologic activity index in females (p=0.047), there were no gender-specific differences. Disease remission was achieved in 41.9% of patients at 6 months, while only 9.3% failed. At the final disposition, remission rates had slightly increased to 58%, but failure rates had risen to 12%. Treatment responses at both 6 and 12 months and MELD and Child-Pugh class influenced treatment responses at final disposition. Median overall survival was 102 weeks and was influenced by the presence of liver dysfunction and 12 months and final treatment responses.
Conclusion:Autoimmune hepatitis remains an important cause of morbidity and mortality. The results of the study highlight the need for immunosuppressive therapy to induce early remission for a higher likelihood of subsequent biochemical remission to reduce the risk of liver-related mortality.
Full text:PJIM 3.pdf