Autoimmune hepatitis: course and prognosis
Last reviewed: 23.04.2024
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The course and prognosis of autoimmune hepatitis is extremely variable. The course has a wavy character with episodes of deterioration, when jaundice and weakness develop. The outcome of the chronic hepatitis thus proceeding, with rare exception, is inevitably cirrhosis.
The 10-year survival rate is 63%. The remission achieved after 2 years of corticosteroid therapy in one third of patients lasts up to 5 years, while two thirds have relapses and require a second course of treatment. With the re-appointment of corticosteroids, there are more side effects. The average life expectancy is 12.2 years. The highest mortality rate is observed during the first 2 years, when the disease is most active. Persistent remission is more typical for cases when the disease is early diagnosed and adequate immunosuppression is achieved. Therapy with corticosteroids prolongs the life of patients, but the majority eventually develops the terminal stage of cirrhosis.
Women in the menopause period respond to initial corticosteroid therapy, but they develop more side effects at a later date.
Patients with HLA-B8, as a rule, young age, they have a picture of a more severe disease at the time of treatment and more often develop relapses.
The dilated esophagus veins are not so common a finding of the early period. Nevertheless, bleeding from varicose veins of the esophagus and hepatic-cell insufficiency are common causes of death.
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