Autoimmune Hepatitis Management: Recent Advances and Future Prospects

Livers Pub Date : 2024-05-15 DOI:10.3390/livers4020017
Rebeca Sierra, Ana Marenco-Flores, Marwan Alsaqa, R. Barba, Marcela Cuellar-Lobo, Carla Barberan, Leandro Sierra
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Abstract

Autoimmune hepatitis (AIH) is a varied inflammatory chronic liver disease. AIH’s prevalence varies and has increased recently. Diagnosis involves the discovery of histologic features following liver biopsy and serologic testing. Clinical features vary, and up to 40% of patients may be asymptomatic. Evaluating thiopurine methyltransferase (TMPM) activity before treatment is crucial for an optimal response. The primary treatment goal is biochemical remission, normalized serum IgG, and liver enzymes. Induction therapy typically involves azathioprine and corticosteroids. Close monitoring of liver function tests and serum immunoglobulin levels is essential. Medications can be tapered after achieving biochemical remission. Liver transplantation may be required for refractory disease or cirrhosis. Further therapeutic approaches are needed, particularly for non-responders to first-line treatments.
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自身免疫性肝炎管理:最新进展与未来展望
自身免疫性肝炎(AIH)是一种多种多样的炎症性慢性肝病。自身免疫性肝炎的发病率各不相同,近来有所上升。诊断需要通过肝活检和血清学检测发现组织学特征。临床特征各不相同,多达 40% 的患者可能没有症状。治疗前评估硫嘌呤甲基转移酶(TMPM)的活性对获得最佳反应至关重要。主要治疗目标是生化缓解、血清 IgG 和肝酶正常化。诱导治疗通常包括硫唑嘌呤和皮质类固醇。密切监测肝功能检查和血清免疫球蛋白水平至关重要。在达到生化缓解后,可逐渐减少用药。难治性疾病或肝硬化可能需要肝移植。需要进一步的治疗方法,尤其是对一线治疗无效者。
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