Natural history and long-term management of autoimmune hepatitis.

IF 3.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 Epub Date: 2025-04-12 DOI:10.1080/17474124.2025.2491531

Matthew K Smith, Aldo J Montano-Loza

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引用次数: 0

Abstract

Introduction: Autoimmune hepatitis (AIH) is a relatively infrequent and complex liver disease characterized by acute or chronic inflammation, interface hepatitis in histology examination, elevation of immunoglobulin G (IgG), production of autoantibodies, and is often responsive to immunosuppression. The incidence of AIH has been increasing worldwide, affecting people of all ages and sexes. AIH represents a diagnostic challenge because of its heterogeneous presentation and the lack of pathognomonic findings. Even when treated, AIH can remain a progressive disease. In this review, we present recent data on the natural history of AIH and the developing evidence on the management of patients with AIH.

Areas covered: This review outlines the clinical presentation, risk factors linked to poorer clinical outcomes, the diagnostic algorithm, and the current management strategies for individuals living with AIH.

Expert opinion: AIH remains a clinical challenge, and new tools for better diagnosis and stratification of risk are needed. In addition, better treatments are needed as a complete response is achieved in less than 60% of cases, and intolerance to first-line treatment is frequent. The use of biological treatment in AIH seems to improve the response rate and minimize the risk of side effects of current medication in this increasingly prevalent disease.

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自身免疫性肝炎的自然病史和长期管理。

自身免疫性肝炎（AIH）是一种相对少见和复杂的肝脏疾病，其特征是急性或慢性炎症，组织学检查为界面肝炎，免疫球蛋白G （IgG）升高，自身抗体产生，通常对免疫抑制有反应。AIH的发病率在世界范围内一直在增加，影响所有年龄和性别的人。AIH是一种诊断挑战，因为它的异质表现和缺乏病理表现。即使得到治疗，艾滋病仍可能是一种进行性疾病。在这篇综述中，我们介绍了AIH自然史的最新数据和AIH患者管理的发展证据。涵盖领域：本综述概述了AIH患者的临床表现、与较差临床结果相关的危险因素、诊断算法和当前的管理策略。专家意见：AIH仍然是一项临床挑战，需要更好地诊断和分层风险的新工具。此外，需要更好的治疗方法，因为只有不到60%的病例获得完全缓解，而且对一线治疗的不耐受现象很常见。在AIH中使用生物治疗似乎可以提高反应率，并将当前药物对这种日益流行的疾病的副作用风险降至最低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.80

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.