Retrospective evaluation of inflammatory markers in autoimmune hepatitis and their place in determining the prognosis of the disease

Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease characterized by elevation of aminotransferases, presence of anti-nuclear or anti-smooth muscle antibody, elevated immunoglobulin G, and interphase hepatitis or plasma-lymphocytic inflammation based on histology. According to studies, the prevalence of AIH is between 10 and 25 per 100,000 population in Europe, while it is between 5 and 25 per 100,000 population in countries located in the Asia-Pacific region. Although a definite prevalence is not specified for our country, there are studies showing that 1.5-1.9% of chronic hepatitis in Turkey is autoimmune hepatitis. The incidence of the disease has been increasing in recent years. The gold standard method used to determine the prognosis of AIH is liver biopsy. This method is both risky and costly in terms of complications. Therefore, non-invasive laboratory parameters that can be used to determine the prognosis of AIH were evaluated retrospectively in our study. The aim of our study; The aim of this study is to compare the ratios of hemogram, transaminases and liver function tests to each other, liver fibrosis levels at the time of admission and first-line treatment responses of autoimmune hepatitis patients, and to evaluate their relationship with the disease prognosis, especially in terms of easy accessibility and cost-effectiveness. In our study, after our patients with AIH who were followed up in Bursa Uludağ University Faculty of Medicine were screened, the files of 95 patients who met the criteria of our study were examined in detail, and their last disease status was checked and recorded. The patients were classified according to the fibrosis levels in the liver biopsies performed at the time of diagnosis and as present/absent remission. Afterwards, statistical analyzes were created by comparing them with the determined parameters. After statistical analyzes, no statistically significant relationship could be established between RDW, NLR, LMR, PLR, AAR, FIB-4, IGPR, PIIV values and the presence of remission (respectively p=0.210, p=0.633, p=0.316, p=0.176, p=0.753, p=0.115, p=0.058, p=0.794). A statistically significant relationship was established between GPR and the presence of remission (p=0.019). Our study reveals that the GPR value can be used to determine the prognosis of the disease. Patients with a GPR > 0.29 have been shown to be significantly less responsive to first-line therapy. Considering the side effects and costs of the drugs used in all treatment steps, the benefits of predicting the prognosis of the disease are obvious. Therefore, our study may contribute to the literature in terms of showing that the GPR value is significant in terms of non-invasively determining the prognosis of AID. Keywords: Autoimmune hepatitis, fibrosis, remission, GGT-platelet ratio.