Autoimmune Hepatitis: A Single-Center Experience on Treatment Response Rates and Their Association with Cirrhosis

Objective: This study aimed to evaluate treatment responses in patients with autoimmune hepatitis (AIH) and overlap syndromes and to investigate the association between treatment response and cirrhosis development.

Methods: Between 2010 and 2025, 469 patients diagnosed with AIH at a single center were screened. After exclusion of patients who did not meet international diagnostic criteria, 234 patients were included and categorized as AIH (n = 130) and AIH with overlap syndrome (AIH+OS; comprising AIH+PBC and AIH+PSC) (n = 104). Demographic characteristics, treatment responses, cirrhosis prevalence, and potential predictors of cirrhosis were recorded. Treatment responses were classified according to International Autoimmune Hepatitis Group criteria.

Results: Median ages were 57 (44–67) and 59 (47–67) years in the AIH and AIH+OS groups, respectively, with female predominance in both groups. Cirrhosis prevalence was similar between groups (36.2% vs. 38.5%; p = 0.689). Complete biochemical response rates were 75.4% in AIH and 72.1% in AIH+OS; insufficient response rates were 19.2% and 16.3%, and non-response rates were 5.4% and 8.7% (p = 0.546). Cirrhosis was more frequent in patients with non-response (93.8%) and insufficient response (76.2%) than in those with complete biochemical response (23.1%) (p < 0.001). Advanced fibrosis at diagnosis was the most common contributing factor (57.5%).

Conclusion: Treatment responses are comparable in AIH and overlap syndromes. Achieving a complete biochemical response is crucial to prevent cirrhosis. Patients with insufficient response, non-response, or advanced fibrosis at diagnosis require close monitoring due to poorer prognosis.

Keywords: autoimmune hepatitis, cirrhosis, overlap syndrome, treatment response.