{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T04:52:36Z","timestamp":1767156756011},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2005,6,9]],"date-time":"2005-06-09T00:00:00Z","timestamp":1118275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2005,8]]},"abstract":"<jats:p><jats:bold>Abstract: <\/jats:bold> Studies on the long\u2010term outcome of immunosuppression in patients with autoimmune hepatitis (AIH) type 1 are limited.<\/jats:p><jats:p><jats:bold>Aim: <\/jats:bold> To assess the efficacy and safety of prolonged medical therapy for up to four decades in a cohort of patients with AIH.<\/jats:p><jats:p><jats:bold>Methods: <\/jats:bold> Forty\u2010two patients were followed long term in the Yale Liver Clinics who met the criteria of \u2018definite autoimmune hepatitis\u2019 as defined by the International Autoimmune Hepatitis Group. Records were reviewed for the dosage of immunosuppression, rate of relapse, steroid side effects, current status of liver function tests and evidence for cirrhosis and its complications.<\/jats:p><jats:p><jats:bold>Results: <\/jats:bold> Mean follow\u2010up was 16 years and ranged from 7 to 43 years. The median follow\u2010up was 13.5 years. Steroid withdrawal resulted in a mean of 1.78 relapses\/patient (range, 0\u20138). All but six patients responded well to prednisone and azathioprine and alanine aminotransferases were completely normal in 29 (81%) at last exam. Five patients have discontinued medication. Steroid side effects have been minimal (weight gain in eight, osteoporosis in three) except for one patient who recovered successfully from cryptococcal meningitis and another with aseptic necrosis of the hip. Progression to cirrhosis occurred in 54% with evidence of esophageal varices in 37% but none developed hepatocellular carcinoma. Only one patient has received a liver transplant, while five others are currently listed because of symptoms of ascites, encephalopathy or bleeding from esophageal varices.<\/jats:p><jats:p><jats:bold>Conclusions: <\/jats:bold> AIH can be managed effectively over three to four decades with low\u2010dose immunosuppression resulting in essentially normal lifestyles and minimal side effects. Liver transplantation with an increased risk of rejection and graft failure in this group can be avoided for long periods in most of these patients.<\/jats:p>","DOI":"10.1111\/j.1478-3231.2005.01141.x","type":"journal-article","created":{"date-parts":[[2005,7,5]],"date-time":"2005-07-05T18:53:21Z","timestamp":1120589601000},"page":"734-739","source":"Crossref","is-referenced-by-count":51,"title":["Autoimmune hepatitis type 1: safety and efficacy of prolonged medical therapy"],"prefix":"10.1111","volume":"25","author":[{"given":"Srinivas","family":"Seela","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harinath","family":"Sheela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James L.","family":"Boyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,6,9]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.qjmed.a067264"},{"key":"e_1_2_6_3_2","article-title":"Clinical, biochemical and histological remission of severe chronic active liver disease","volume":"63","author":"Soloway R D","year":"1972","journal-title":"a controlled study of treatments and early prognosis"},{"key":"e_1_2_6_4_2","first-page":"734","article-title":"Controlled trial of prednisone and azathioprine in active chronic hepatitis","author":"Murray\u2010Lyon I M","year":"1973","journal-title":"Lancet"},{"key":"e_1_2_6_5_2","first-page":"876","article-title":"Prednisone for chronic active liver disease","volume":"16","author":"Summerskill W H J","year":"1975","journal-title":"dose titration, standard dose and combination with azathioprine compound"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(05)80005-4"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.v110.pm8608895"},{"key":"e_1_2_6_8_2","first-page":"890","article-title":"Sustained remission after corticosteroid therapy for type 1 autoimmune hepatitis","volume":"35","author":"Czaja A J","year":"2002","journal-title":"a retrospective analysis"},{"key":"e_1_2_6_9_2","first-page":"131","article-title":"Long\u2010term follow\u2010up after liver transplantation for autoimmune hepatitis","volume":"30","author":"Ratziu V","year":"1999","journal-title":"evidence of recurrence of primary disease"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-198404000-00009"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199201000-00027"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/lt.500010305"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(96)00223-0"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-199707000-00003"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199812270-00013"},{"key":"e_1_2_6_16_2","first-page":"131","article-title":"Long\u2010term follow\u2010up after liver transplantation for autoimmune hepatitis","volume":"30","author":"Ratziu V","year":"1999","journal-title":"evidence of recurrence of primary disease"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199907270-00016"},{"key":"e_1_2_6_18_2","first-page":"43","article-title":"Recurrence of autoimmune hepatitis after liver transplantation","volume":"31","author":"Gotz G","year":"1993","journal-title":"Transpl Proc"},{"key":"e_1_2_6_19_2","first-page":"1955","article-title":"Liver transplantation for autoimmune hepatitis","volume":"31","author":"Narumi S","year":"1993","journal-title":"rejection and recurrence"},{"key":"e_1_2_6_20_2","first-page":"185","article-title":"Liver transplantation for autoimmune hepatitis","volume":"32","author":"Ayata G","year":"2000","journal-title":"a long-term pathologic study"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2000.16666"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1053\/jlts.2001.21449"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840150208"},{"issue":"4","key":"e_1_2_6_24_2","first-page":"285","article-title":"Recurrent autoimmune hepatitis after liver transplantation","volume":"7","author":"Hubscher S G.","year":"2001","journal-title":"diagnostic criteria, risk factors, and outcome"},{"key":"e_1_2_6_25_2","first-page":"893","article-title":"A 10 year follow up study of patients transplanted for autoimmune hepatitis","volume":"52","author":"Duclos\u2010Vallee J\u2010C","year":"2003","journal-title":"histological recurrence precedes clinical and biochemical recurrence"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(99)80297-9"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199510123331502"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(00)00095-7"},{"key":"e_1_2_6_29_2","first-page":"1502","article-title":"Autoimmune hepatitis","volume":"120","author":"Manns M P","year":"2001","journal-title":"clinical challenges"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1478-3231.2005.01141.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1478-3231.2005.01141.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T12:19:27Z","timestamp":1697285967000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1478-3231.2005.01141.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,6,9]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2005,8]]}},"alternative-id":["10.1111\/j.1478-3231.2005.01141.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1478-3231.2005.01141.x","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,6,9]]}}}