109 TREATMENT PROFILE OF AUTOIMMUNE HEPATITIS IN A BRAZILIAN TERTIARY HOSPITAL

Abstract

Introduction: Autoimmune hepatitis (IAH) is a rare disease, marked by periods of inflammation and remission. It occurs in any age group with a bimodal incidence. The aim of IAH treatment is to achieve a complete normalization of the levels of aminotransferase and immunoglobulin and to remain remission after treatment withdrawal and to reduce the development of cirrhosis and its complications. Objective: Our study evaluated the profile of treatment response IAH patients and identify variables related to biochemical and histological remission. Methodology: Descriptive, retrospective and observational study, with analysis of data from the medical records of patients, from July 2002 to July 2020, with the inclusion of patients diagnosed with IAH and patients with intake of alcoholic beverages, infected with viral hepatitis, with drug-induced injury or who had overlap syndromes were excluded from the study. Results: 35 adults with IAH were included, the average age at the diagnosis was 54.7 ± 14.2 years. All received corticosteroids and azathioprine. Side effects were observed in 28% of cases. A biochemical remission was achieved in 85% of patients and to those who underwent a new liver biopsy after treatment withdrawal, we found 68% of histological remission. Relapsed rate observed after treatment withdrawal was 35% (5/14), all of them in the first year of follow up. High levels of serum albumin was a positive factor for biochemical remission otherwise high titers of anti-smooth muscle antibody showed a worse rate of histological remission. Conclusion: The response of treatment were similar to observed in European and North-American studies and minimum side effects were reported. Finally, patients with antismooth muscle antibody positivity achieved a lower histological response and such patients should be considered optimization of standard treatment.