Clinical Features, Treatment Challenges and Outcomes of Patients with Autoimmune Hepatitis : Five Years Experience in Rīga East University Hospital

Abstract

Autoimmune hepatitis is an inflammatory disease of the liver of unknown aetiology that can progress to liver cirrhosis and end-stage liver failure. The clinical presentation is often acute hepatitis, but can be insidious or completely asymptomatic. It is characterised by an increase in serum transaminases and immunoglobulin G, an inflammatory liver histology, and the presence of circulating autoantibodies. An autoimmune hepatitis diagnosis justifies lifelong treatment in most patients to prevent the development of cirrhosis and end-stage liver disease. The cornerstone of treatment is steroid induction therapy followed by maintenance therapy with azathioprine, which is effective in most cases. Treatment should be optimised to reach these aims with a minimum of side effects. To achieve optimal results, individual treatment regimens and compromises between treatment aims and personal choices are needed. The aim of the study was to collect data on the clinical course, therapy, and results of autoimmune hepatitis, on the compliance of treatment choice with the criteria for starting therapy. A retrospective cohort study was conducted using data from the Rîga Eastern University Hospital Archives for the period 2019–2023. The study group consisted of 37 patients diagnosed with autoimmune hepatitis who were hospitalised or consulted in an outpatient clinic during the above period. Information relating to the patient's electronic medical records were obtained and no additional sources were used. In the study, it was found that the clinical and diagnostic criteria of autoimmune hepatitis in Rîga Eastern Clinical University Hospital over a five-year period usually correspond to the generally accepted diagnostic principles, but the therapeutic approach does not always correspond to the guidelines, especially regarding the duration of therapy.