Abstracts of the 2025 Annual Meeting of the ALEH
More infoAutoimmune hepatitis (AIH) is a chronic inflammatory liver disease associated with significant morbidity. Non-white ethnicity has been described as an independent predictor of adverse outcomes. Previous studies suggest a more severe disease phenotype in Latin America. We aim to describe the presentation, treatment, and outcomes of AIH in Latin America.
Materials and MethodsRetrospective, ongoing, multicenter cohort study (ALLATIN) including 515 patients with autoimmune hepatitis from Brazil (246), Argentina (108), Chile (71), Ecuador (28), Cuba (22), Mexico (21), Costa Rica (10), and Peru (1).
ResultsMost patients were female (82.5%), with type 1 AIH (90.9%) and a mean age at diagnosis of 42.8±19.2 years. At disease presentation, the most reported symptom was jaundice (42.3%), followed by asthenia (25.3%), abdominal pain (19.8%), arthralgia (10.0%) and pruritus (9.8%). Clinical signs of portal hypertension were seen in 16.1% at diagnosis. Acute presentation occurred in 39.3%, predominantly as acute icteric hepatitis(72.2%), while 42% were asymptomatic. At the first biopsy, 42.9% of patients had advanced fibrosis (F3–F4), 35.0% were cirrhotic on ultrasound, and 26.6% had clinically significant portal hypertension. The preferred first line therapy was prednisone (96.5%) and azathioprine (91.9%). Biochemical remission was achieved in 68.4% (data from 336 patients) at 6 months and 55.7% at 12 months and 55.7% (data from 329 patients) at 12 months. Among patients who achieved a biochemical response within the first year, most responded within the first 6 months. Reported second-line therapies were mycophenolate mofetil (63.6%), tacrolimus (13.6%), cyclosporine (13.6%), chloroquine (6.8%), and rituximab (2.3%). In a mean follow up of 6.72±6.0 years, 3.9% underwent liver transplantation and 3.1% died.
ConclusionsDespite a high burden of advanced liver disease at presentation, the ALLATIN cohort shows comparable treatment response rates to European populations. These findings highlight the importance of ethnicity, healthcare access, and early diagnosis in shaping AIH outcomes.
Conflict of interest: None
