Batna Journal of Medical Sciences
Volume 13, Numéro 8, Pages 631-639
2026-07-30

Diagnostic And Prognostic Evaluation Of Patients With Autoimmune Hepatitis (aih): About 176 Cases



Authors : Boudjella Mohamed Lotfi . Boudjella Mohamed Elamine . Bellagh Wissem . Khalouf Mohamed Raouf . Bouteflika Djihane . Chadi Youcef . Menzou Farouk . Seridj Nardjes . Naili Nabila . Bouali-benhalima. Malika . Siahmed Bouali Djamila . Meghlaoui Ali .

Abstract

Introduction: Autoimmune hepatitis (AIH) is a chronic immune-mediated inflammatory liver disease that may present in either an acute or a chronic form. It predominantly occurs in genetically predisposed individuals and may progress to cirrhosis in the absence of appropriate treatment. The aim of this study was to investigate the clinical, immunological, and prognostic characteristics of AIH. Patients and Methods: This retrospective cross-sectional descriptive and analytical study included 176 Algerian patients with clinical features suggestive of AIH who were recruited between September 2012 and December 2025 at the Immunology Unit of Blida University Hospital. Patients were selected according to the diagnostic criteria established by the International Autoimmune Hepatitis Group (IAIHG), including immunological findings (specific autoantibody titers and serum IgG levels), compatible liver histology, and the exclusion of viral hepatitis. Results: Among the 176 patients with AIH, 130 were women (74%) and 46 were men (26%), corresponding to a female-to-male ratio of 3:1. The mean age was 53.0 ± 11.62 years (59.27 ± 13.32 years in women and 37.48 ± 9.10 years in men). The most frequent biological abnormalities were elevated IgG levels, hypoalbuminemia, and elevated IgM levels (45%, 23%, and 19%, respectively). Anti-smooth muscle antibodies (ASMA) were detected in 73.29% of patients (129/176), while anti-LKM-1 autoantibodies were detected in 11.36% (20 patients) and were mainly associated with type 2 AIH, together with anti-LC-1 autoantibodies. Regarding associated autoimmune diseases, 11 patients presented an AIH–primary biliary cholangitis (PBC) overlap syndrome with positive anti-mitochondrial antibodies, eight had autoimmune thyroid disease, three had systemic lupus erythematosus (SLE), four had sicca syndrome, and six had confirmed antiphospholipid syndrome. Delayed diagnosis was associated with an approximately eightfold increased risk of developing cirrhosis compared with early diagnosis. Conclusion: Autoantibody testing remains a cornerstone in the diagnosis of AIH and is also essential for identifying associated autoimmune diseases. Despite advances in diagnosis and management, AIH remains associated with an unfavorable prognosis in some patients, highlighting the need to identify reliable biomarkers capable of predicting disease progression.

Keywords

Autoimmune hepatitis ; autoantibodies ; diagnosis

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