Hepatology international · 2026
Genuine acute autoimmune hepatitis has better therapeutic response and prognosis.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shen Yi, Zhou Dan, Sun Jie, Wang Xiaoze, Men Ruoting, Wen Maoyao, Fan Xiaoli, Wang Xianglin, Yang Fan, Yang Li
Аннотация
BACKGROUND AND AIM: Heterogeneous diagnostic criteria for acute autoimmune hepatitis (AIH) across studies hinder the characterization of genuine acute AIH. We developed stringent and multidimensional criteria to distinguish acute, acute-on-chronic, and chronic autoimmune hepatitis (A-AIH, AC-AIH, and C-AIH), aiming to elucidate their clinical profiles.
METHODS: We consecutively enrolled patients diagnosed with definite AIH between 2012 and 2024. All patients were stratified using stringent criteria encompassing onset time (A-AIH: < 6 months), acute presentation (total bilirubin (TB) ≥ 5 mg/dL or alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ≥ 10 × upper limits of normal (ULN)), imaging evidence of cirrhosis, and histological fibrosis stage (A-AIH: fibrosis stage ≤ 1). Clinical features and treatment responses were compared across the three groups.
RESULTS: Among 235 patients, 10.6% were classified as A-AIH, 57.9% as AC-AIH, and 31.5% as C-AIH, with a median follow-up of 51.9 (IQR 21.8-78.8) months. The cumulative full biochemical remission (FBR) rate was 92.0% in A-AIH, 75.7% in AC-AIH, and 59.5% in C-AIH (p = 0.003). The median FBR times were 2.9, 5.5, and 14.5 months, respectively (p = 0.002). Liver-related mortality rates were 0%, 8.8%, and 16.2% across the three groups (p = 0.021). Cirrhosis and albumin (ALB) levels were independent predictors of FBR, and ALB was also independently associated with liver-related death.
CONCLUSION: Patients with A-AIH achieved the highest cumulative FBR rate, whereas those with C-AIH had the poorest treatment response and the highest liver-related mortality.
METHODS: We consecutively enrolled patients diagnosed with definite AIH between 2012 and 2024. All patients were stratified using stringent criteria encompassing onset time (A-AIH: < 6 months), acute presentation (total bilirubin (TB) ≥ 5 mg/dL or alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ≥ 10 × upper limits of normal (ULN)), imaging evidence of cirrhosis, and histological fibrosis stage (A-AIH: fibrosis stage ≤ 1). Clinical features and treatment responses were compared across the three groups.
RESULTS: Among 235 patients, 10.6% were classified as A-AIH, 57.9% as AC-AIH, and 31.5% as C-AIH, with a median follow-up of 51.9 (IQR 21.8-78.8) months. The cumulative full biochemical remission (FBR) rate was 92.0% in A-AIH, 75.7% in AC-AIH, and 59.5% in C-AIH (p = 0.003). The median FBR times were 2.9, 5.5, and 14.5 months, respectively (p = 0.002). Liver-related mortality rates were 0%, 8.8%, and 16.2% across the three groups (p = 0.021). Cirrhosis and albumin (ALB) levels were independent predictors of FBR, and ALB was also independently associated with liver-related death.
CONCLUSION: Patients with A-AIH achieved the highest cumulative FBR rate, whereas those with C-AIH had the poorest treatment response and the highest liver-related mortality.