Type 1 and Type 2 Autoimmune Hepatitis: Key Similarities
By Craig Lammert, M.D., AIHA Executive Director
Doctors have long recognized two types of autoimmune hepatitis (AIH): Type 1 and Type 2. Type 2 AIH, marked by the antibodies anti-LKM1 or LC1, appears more common in children than in adults.
Earlier studies suggested it caused more severe liver inflammation, required more transplants, and was harder to control. It was also believed that patients with Type 2 AIH struggled more to stop immunosuppressive therapy.
New Research Challenges Old Assumptions
Authors of a new paper published this year highlight an expanded experience that may change some thinking. The paper, available in the Journal of Hepatology, describes the experience of 117 children with AIH with a median follow-up time of 20 years from a single center in Italy. Included in this study: 65 patients with Type 1 AIH and 52 with Type 2 AIH.
Study Findings and Key Takeaways
Key takeaway: There was no difference observed between the Type 1 and Type 2 patients regarding any outcome followed – including differences in ability to normalize liver tests, success of removing therapy, and overall survival and need for transplantation.
This is a very different message than promoted from older studies with less follow-up.
Treatment Outcomes
The authors found that normalization of liver tests was observed in more than 90% of patients, and 19% were able to have immunosuppression removed without increased liver tests for more than four years of follow-up. Many patients are treated with medications like azathioprine, which has been a standard therapy for decades. However, recent research has explored azathioprine alternatives for autoimmune hepatitis that may offer improved tolerance and effectiveness for some individuals.
Long-Term Survival Rates
Eighty-five percent of patients were alive at the end of study follow-up. The estimated survival was 94% at 10 years beyond diagnosis, 85% at 20 years, and 81% at 30 years. This is great news – especially since many (80 out of the 117 patients) had cirrhosis at diagnosis.
What This Means for Patients and Families
Conclusion: Type 1 and Type 2 AIH may have similar responses and outcomes, which are generally good. This is reassuring news for patients and their families.
Ultimately, the authors did see that patients with abnormally long prothrombin time (a measure of liver function) may have a higher risk of needing a liver transplant during follow-up.
You can read more in the original article here.
Join the Autoimmune Hepatitis Association
For more information on topics like type 1 and type 2 autoimmune hepatitis differences and other aspects of living with AIH, become a member of the Autoimmune Hepatitis Association. Connect with others who understand your journey, stay informed on the latest research, and get first access to educational content and event tickets.
Recent Comments