{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T21:59:58Z","timestamp":1778882398653,"version":"3.51.4"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The evaluation of liver fibrosis is essential in the management of patients with autoimmune hepatitis (AIH). We aimed to establish and validate an easy-to-use nomogram to identify AIH patients with advanced liver fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>AIH patients who underwent liver biopsies were included and randomly divided into a training set and a validation set. The least absolute shrinkage and selection operator (LASSO) regression was used to select independent predictors of advanced liver fibrosis from the training set, which were utilized to establish a nomogram. The performance of the nomogram was evaluated using the receiver characteristic curve (ROC), calibration curve, and decision curve analysis (DCA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age of 235 patients with AIH was 54 years old, with 83.0% of them being female. Six independent factors associated with advanced fibrosis, including sex, age, red cell distribution width, platelets, alkaline phosphatase, and prothrombin time, were combined to construct a predictive AIH fibrosis (AIHF)-nomogram. The AIHF-nomogram showed good agreement with real observations in the training and validation sets, according to the calibration curve. The AIHF-nomogram performed significantly better than the fibrosis-4 and aminotransferase-to-platelet ratio scores in the training and validation sets, with an area under the ROCs for predicting advanced fibrosis of 0.804 in the training set and 0.781 in the validation set. DCA indicated that the AIHFI-nomogram was clinically useful. The nomogram will be available at <jats:ext-link>http:\/\/ndth-zzy.shinyapps.io\/AIHF-nomogram\/<\/jats:ext-link>as a web-based calculator.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The novel, easy-to-use web-based AIHF-nomogram model provides an insightful and applicable tool to identify AIH patients with advanced liver fibrosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2023.1130362","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T04:45:10Z","timestamp":1684298710000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["An easy-to-use AIHF-nomogram to predict advanced liver fibrosis in patients with autoimmune hepatitis"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhiyi","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huali","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanwang","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiacheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiguang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yilin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengxia","family":"Yin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Tong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomin","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yali","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongfeng","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuanwu","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"58","DOI":"10.3350\/cmh.2020.0189","article-title":"Recent updates on the management of autoimmune hepatitis","volume":"27","author":"Komori","year":"2021","journal-title":"Clin Mol Hepatol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldv021","article-title":"Autoimmune hepatitis: an approach to disease understanding and management","volume":"114","author":"Corrigan","year":"2015","journal-title":"Br Med Bull"},{"key":"B3","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1053\/j.gastro.2010.04.053","article-title":"Advances in the diagnosis, pathogenesis, and management of autoimmune hepatitis","volume":"139","author":"Czaja","year":"2010","journal-title":"Gastroenterology"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-070201","article-title":"Diagnosis and management of autoimmune hepatitis","volume":"380","author":"Muratori","year":"2023","journal-title":"BMJ"},{"key":"B5","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1002\/hep.31065","article-title":"Diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American association for the study of liver diseases","volume":"72","author":"Mack","year":"2020","journal-title":"Hepatology"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2174\/138955709788452676","article-title":"Diagnosis and therapy of autoimmune hepatitis","volume":"9","author":"Granito","year":"2009","journal-title":"Mini Rev Med Chem"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23584","article-title":"Diagnosis and management of autoimmune hepatitis","volume":"51","author":"Manns","year":"2010","journal-title":"Hepatology"},{"key":"B8","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1016\/j.jhep.2015.06.030","article-title":"EASL clinical practice guidelines: autoimmune hepatitis","volume":"63","year":"2015","journal-title":"J Hepatol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.688091","article-title":"A non-invasive model for predicting liver inflammation in chronic hepatitis b patients with normal serum alanine aminotransferase levels","volume":"8","author":"Li","year":"2021","journal-title":"Front Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.jhep.2008.07.039","article-title":"Exceeding the limits of liver histology markers","volume":"50","author":"Mehta","year":"2009","journal-title":"J Hepatol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinre.2021.101772","article-title":"Non-invasive diagnosis and follow-up of autoimmune hepatitis","volume":"46","author":"Lemoinne","year":"2022","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2003.50346","article-title":"A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis c","volume":"38","author":"Wai","year":"2003","journal-title":"Hepatology"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21178","article-title":"Development of a simple noninvasive index to predict significant fibrosis in patients with HIV\/HCV coinfection","volume":"43","author":"Sterling","year":"2006","journal-title":"Hepatology"},{"key":"B14","unstructured":"GenevaWorld Health OrganizationGuidelines for the prevention, care and treatment of persons with chronic hepatitis b infection2015"},{"key":"B15","unstructured":"GenevaWorld Health OrganizationGuidelines for the screening care and treatment of persons with chronic hepatitis c infection: updated version2016"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2018.07.030","article-title":"Noninvasive indices for monitoring disease course in Chinese patients with autoimmune hepatitis","volume":"486","author":"Zeng","year":"2018","journal-title":"Clin Chim Acta"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.22922","article-title":"Noninvasive indicators predict advanced liver fibrosis in autoimmune hepatitis patients","volume":"33","author":"Liu","year":"2019","journal-title":"J Clin Lab Anal"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13508","article-title":"Evaluation of transient elastography in assessing liver fibrosis in patients with autoimmune hepatitis","volume":"32","author":"Xu","year":"2017","journal-title":"J\u00a0Gastroenterol Hepatol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12696","article-title":"Development of algorithms based on serum markers and transient elastography for detecting significant fibrosis and cirrhosis in chronic hepatitis b patients: significant reduction in liver biopsy","volume":"46","author":"Li","year":"2016","journal-title":"Hepatol Res"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25993","article-title":"Determination of reliability criteria for liver stiffness evaluation by transient elastography","volume":"57","author":"Boursier","year":"2013","journal-title":"Hepatology"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i5.859","article-title":"Magnetic resonance elastography is accurate in detecting advanced fibrosis in autoimmune hepatitis","volume":"23","author":"Wang","year":"2017","journal-title":"World J Gastroenterol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12072-016-9760-3","article-title":"Asian-Pacific association for the study of the liver (APASL) consensus guidelines on invasive and non-invasive assessment of hepatic fibrosis: a 2016 update","volume":"11","author":"Shiha","year":"2017","journal-title":"Hepatol Int"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/s0168-8278(99)80297-9","article-title":"International autoimmune hepatitis group report: review of criteria for diagnosis of autoimmune hepatitis","volume":"31","author":"Alvarez","year":"1999","journal-title":"J Hepatol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8278(91)90084-o","article-title":"Classification of chronic viral hepatitis: a need for reassessment","volume":"13","author":"Scheuer","year":"1991","journal-title":"J\u00a0Hepatol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-022-08935-z","article-title":"Serum biomarkers for autoimmune hepatitis type 1: the case for CD48 and a review of the literature","volume":"63","author":"Hu","year":"2022","journal-title":"Clin Rev Allergy Immunol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22112","article-title":"Optical analysis of computed tomography images of the liver predicts fibrosis stage and distribution in chronic hepatitis c","volume":"47","author":"Romero-G\u00f3mez","year":"2008","journal-title":"Hepatology"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000021408","article-title":"Red cell distribution width to platelet ratio predicts liver fibrosis in patients with autoimmune hepatitis","volume":"99","author":"Wang","year":"2020","journal-title":"Med (Baltimore)"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.12.012","article-title":"Autoimmune hepatitis","volume":"55","author":"Lohse","year":"2011","journal-title":"J Hepatol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1007\/s11684-015-0386-y","article-title":"Autoimmune hepatitis","volume":"9","author":"Sahebjam","year":"2015","journal-title":"Front Med"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0023077","article-title":"A new model using routinely available clinical parameters to predict significant liver fibrosis in chronic hepatitis b","volume":"6","author":"Seto","year":"2011","journal-title":"PloS One"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000250","article-title":"Serum biomarkers predictive of significant fibrosis and cirrhosis in chronic hepatitis b","volume":"49","author":"Lin","year":"2015","journal-title":"J Clin Gastroenterol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.ajg.2016.05.002","article-title":"FibroScan, APRI, FIB4, and GUCI: role in prediction of fibrosis and response to therapy in Egyptian patients with HCV infection","volume":"17","author":"Yosry","year":"2016","journal-title":"Arab J Gastroenterol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2015.05.004","article-title":"The epidemiological changes of HCV and HBV infections in the era of new antiviral therapies and the anti-HBV vaccine","volume":"9","author":"Stasi","year":"2016","journal-title":"J\u00a0Infect Public Health"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.927946","article-title":"Red blood cell distribution width-to-Platelet ratio and other laboratory indices associated with severity of histological hepatic fibrosis in patients with autoimmune hepatitis: a retrospective study at a single center","volume":"26","author":"Li","year":"2020","journal-title":"Med Sci Monit"},{"key":"B35","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/s12072-018-9907-5","article-title":"Systematic review: diagnostic accuracy of non-invasive tests for staging liver fibrosis in autoimmune hepatitis","volume":"13","author":"Wu","year":"2019","journal-title":"Hepatol Int"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.05.023","article-title":"Transient elastography in autoimmune hepatitis: timing determines the impact of inflammation and fibrosis","volume":"65","author":"Hartl","year":"2016","journal-title":"J Hepatol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"18017","DOI":"10.1038\/nrdp.2018.17","article-title":"Autoimmune hepatitis","volume":"4","author":"Mieli-Vergani","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"B38","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.jaut.2016.07.005","article-title":"Cutting edge issues in autoimmune hepatitis","volume":"75","author":"Liberal","year":"2016","journal-title":"J Autoimmun"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02488.x","article-title":"Clinical features of type 1 autoimmune hepatitis in elderly Italian patients","volume":"21","author":"Granito","year":"2005","journal-title":"Aliment Pharmacol Ther"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21074","article-title":"Distinctive clinical phenotype and treatment outcome of type 1 autoimmune hepatitis in the elderly","volume":"43","author":"Czaja","year":"2006","journal-title":"Hepatology"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000203","article-title":"Clinical usefulness of mean platelet volume and red blood cell distribution width to platelet ratio for predicting the severity of hepatic fibrosis in chronic hepatitis b virus patients","volume":"26","author":"Karagoz","year":"2014","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12342","article-title":"Red cell distribution width as a potential index to assess the severity of hepatitis b virus-related liver diseases","volume":"44","author":"Huang","year":"2014","journal-title":"Hepatol Res"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2013.19.3.258","article-title":"Elevated red cell distribution width is associated with advanced fibrosis in NAFLD","volume":"19","author":"Kim","year":"2013","journal-title":"Clin Mol Hepatol"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003114","article-title":"Red blood cell distribution width to platelet ratio is related to histologic severity of primary biliary cirrhosis","volume":"95","author":"Wang","year":"2016","journal-title":"Med (Baltimore)"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000001447","article-title":"Red blood cell distribution width for predicting significant liver inflammation in patients with autoimmune hepatitis","volume":"31","author":"Wang","year":"2019","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.19501","article-title":"A novel predictive model using routinely clinical parameters to predict liver fibrosis in patients with chronic hepatitis b","volume":"8","author":"Wang","year":"2017","journal-title":"Oncotarget"},{"key":"B47","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12876-022-02098-z","article-title":"Serum ferritin levels are associated with advanced liver fibrosis in treatment-naive autoimmune hepatitis","volume":"22","author":"Chen","year":"2022","journal-title":"BMC Gastroenterol"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2021.103389","article-title":"A novel nomogram to predict evident histological liver injury in patients with HBeAg-positive chronic hepatitis b virus infection","volume":"67","author":"Chang","year":"2021","journal-title":"EBioMedicine"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-010-9189-z","article-title":"Reduction of liver stiffness following resolution of acute flares of chronic hepatitis b","volume":"4","author":"Fung","year":"2010","journal-title":"Hepatol Int"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.1130362\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T04:45:21Z","timestamp":1684298721000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.1130362\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,17]]},"references-count":49,"alternative-id":["10.3389\/fimmu.2023.1130362"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2023.1130362","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,17]]},"article-number":"1130362"}}