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Autoimmune Hepatitis - Course and Prognosis

 
, medical expert
Last reviewed: 06.07.2025
 
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The course and prognosis of autoimmune hepatitis are extremely variable. The course is undulating with episodes of deterioration, when jaundice and weakness increase. The outcome of chronic hepatitis proceeding in this way, with rare exceptions, is inevitably cirrhosis.

The 10-year survival rate is 63%. Remission achieved after 2 years of corticosteroid therapy lasts up to 5 years in a third of patients, while relapses occur in two-thirds and a second course of treatment is required. More side effects are observed with repeated administration of corticosteroids. 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. Sustained remission is more typical for cases where the disease is diagnosed early and adequate immunosuppression is achieved. Corticosteroid therapy prolongs the life of patients, but most eventually develop end-stage cirrhosis.

Postmenopausal women respond to initial corticosteroid therapy but develop more late-term side effects.

Patients with HLA-B8 are usually young, they have a more severe disease at the time of treatment and relapses develop more often.

Esophageal varices are not a common early finding. However, esophageal variceal hemorrhage and hepatocellular failure are common causes of death.

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