Characteristics and Factors Associated with Inflammatory Activity on Liver Biopsy in Autoimmune Hepatitis Patients Aged 50 Years or Older

Abstract

Introduction: Autoimmune hepatitis is an inflammatory liver disorder histologically characterized by portal lymphoplasmocytic hepatitis with interface activity and lobular inflammation. Aims: To identify clinical characteristics associated with older age and also to pinpoint clinical characteristics associated with significant inflammation in liver histology. Methods: Cross-sectional analytical study that evaluated medical records of adult patients with autoimmune hepatitis seen at the Gastroenterology and Hepatology Outward of a Tertiary University Hospital. Bivariate analysis was performed to identify the characteristics associated with age equal or greater than 50 years and the significant histological inflammatory activity. Results: Forty-seven patients were included, with their mean age of 42.8±16.0 (43.0) years. Furthermore, 80.9% of them were women, 31.9% were 50 years-old or older.  Thirty-one patients were submitted to liver biopsy and 29.0% presented significant inflammation. When compared in terms of age, individuals equal or higher 50 years old presented higher medians of GGT (129 vs. 282 U/L; P = 0.034) and a higher proportion of significant inflammation (50 vs. 6.7%; P = 0,024). Patients with significant inflammation on the liver biopsy presented a higher mean age (63.7±14.0 vs. 41.0±14.4; P = 0.001), and a greater proportion of patients equal or above 50 years old (85.7% vs. 66.7%; P=0.024) than individuals with mild inflammation. Conclusions: Individuals equal or higher 50 years old presented higher medians of GGT levels and a greater proportion of significant inflammation on liver histology.