Patients with autoimmune hepatitis and decompensated cirrhosis achieved hepatic recompensation following immunosuppressive therapy, according to a new study. The research also identified key clinical and inflammatory factors linked to recovery.
AIH is a chronic immune-mediated liver disease. Decompensated cirrhosis develops when complications like ascites or variceal bleeding emerge, signaling declining liver function and a worse prognosis.
The study included 81 patients with biopsy-confirmed AIH and decompensated cirrhosis at West China Hospital of Sichuan University. All received immunosuppressive therapy. 34.6% achieved recompensation, with a median time of 32.1 months.
Patients who recompensated had higher baseline BMI, albumin, and ALT levels. Diabetes was less common in this group. Mild ascites was more frequent in recompensated patients, while large-volume ascites and bleeding were more common in those who remained decompensated.
Higher BMI, albumin, ALT, and complete biochemical remission at six months were independent predictors of recompensation. Diabetes reduced the likelihood of recovery.
Patients who achieved recompensation also had lower baseline levels of inflammatory cytokines like IL-17A, TNF-α, and IFN-γ. This suggests a less pronounced inflammatory environment supports recovery.
Over 80% of recompensated patients improved from Child-Pugh class B to class A; the rest improved from class C to class A.
The findings highlight the importance of early risk stratification in AIH-related decompensated cirrhosis. Baseline nutritional status, preserved synthetic function, and metabolic comorbidities like diabetes may help identify patients with greater potential for recovery during immunosuppressive treatment.