Association between the rapidity of response and progression to cirrhosis in patients with autoimmune hepatitis

Objective To evaluate the association between the rapidity of response and progression to cirrhosis in patients with autoimmune hepatitis (AIH) , and to analyze the influencing factors for the rapidity of response.Methods A retrospective analysis was performed on 61 AIH patients with long-term follow-up, who visited The General Hospital of Tianjin Medical University from November 2001 to May 2017.These patients were divided into five groups according to the time for transaminase to decrease to a normal level:< 3 months group, 3-6 months group, 6-12 months group, 12-24 months group, and > 24 months group.The chi-square test was used to compare the rate of progression to cirrhosis and sustained response rate between these groups.One-way analysis of variance and the two-independent-samples t test were used to analyze the influencing factors for the rapidity of response.The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups, and one-way analysis of variance was used for comparison between multiple groups; the chi-square test was used for comparison of categorical data between two groups, and the contingency table chi-square test was used for comparison between multiple groups.Results The < 3 months group had the lowest proportion of patients with progression to cirrhosis (20%) ; all of the two patients in the > 24 months group progressed to cirrhosis; and 62.5% of the patients in the 12-24 months group progressed to cirrhosis.The rate of progression to cirrhosis was significantly lower in the patients who showed response within 3 months than in those who showed no response within 3 months (20% vs 48.15%, χ2= 5.067, P < 0.05) .The rates of progression to cirrhosis for the < 3 months group, 3-6 months group, 6-12 months group, 12-24 months group, and > 24 months group were 20%, 41.7%, 20%, 62.5%, and 100%, respectively, and the < 3 months group had a significantly lower rate of progression to cirrhosis than the 12-24 months group and > 24 months group (χ2= 5.546 and 6.400, both P < 0.05) .The sustained response rate of the < 3 months group was significantly higher than that of the 12-24 months group and > 24 months group (χ2= 4.322, P < 0.05) .Conclusion For AIH patients, the rapidity of response is associated with progression to cirrhosis; a rapid response reduces the rate of progression to cirrhosis.Responding within 3 months may indicate a good outcome, while responding beyond 1 year may indicate a poor outcome.Initial alanine aminotransferase level, and therapeutic drugs may influence the rapidity of response.