Long‐Term Outcomes of Autoimmune Hepatitis

Long-term mortality of patients with autoimmune hepatitis (AIH) remains substantial, despite standard treatment. Published all-cause death/liver transplant rates over 10 and 20 years 1-11 (Table 1) are median (range) 13% (5%-26%) and 31% (18%-53%), respectively. There is minimal infor-mation beyond 20 years. Of all deaths/transplants, 49% (0%-73%) are due to liver disease. The overall number of liver-related deaths is three times the number of trans-plants. Hepatocellular carcinoma (HCC) occurs about once per 100 patient-years 12 (less frequently than in chronic viral hepatitis) and accounts for 27% (7%-70%) of liver-related deaths. 3-7,10 Risk factors for HCC in AIH include cirrhosis (nearly always present), older age, male sex, and less consistently, multiple relapses and alcohol excess. 12 at 7