An analysis on the predicting factors of progressive liver fibrosis (≥F3) in autoimmune hepatitis patients

Abstract

Abstract: Objective Identify the clinical predictors of advanced hepatic fibrosis (≥F3 stage) in patients with autoimmune hepatitis (AIH) through retrospective cohort analysis, and to provide evidence for early risk stratification and intervention. Methods The clinical data of 113 AIH inpatients admitted to the department of hepatology, Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University between November 2021 and June 2024 were retrospectively analyzed. Parameters including demographic characteristics, liver function indices of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (γ-GT), albumin (Alb), serological markers of Immunoglobulin G (IgG), blood platelet (PLT) and non-invasive fibrosis scores including Fibrosis 4 score (FIB-4), AST to platelet ratio index (APRI), GGT-to-platelet ratio (GPR). Based on histopathological staging, patients were categorized into an advanced fibrosis (≥F3, n=47) and a non-advanced fibrosis (<F3, n=66) groups. Multivariate logistic regression analysis was performed to identify the independent predictors of advanced hepatic fibrosis. Results Female patients comprised 87.0% (98/113) of the cohort, with a mean age of 51.8±10.0 years. The prevalence of advanced fibrosis was 41.6%. The advanced fibrosis group exhibited significantly lower platelet counts (PLT: 143.00 [98.00~196.00]×10⁹/L, P<0.05) and albumin levels (Alb: 33.57 [29.10~38.60]g/L, P<0.05), alongside elevated FIB-4 (5.57 [3.58~11.16], P<0.05) and APRI scores (3.77 [1.90~7.65], P<0.05). Multivariate analysis identified PLT (OR=0.991, 95% CI: 0.984~0.998, P=0.014) and ALB (OR=0.900, 95% CI: 0.820~0.988, P=0.027) as independent predictors of advanced fibrosis, suggesting that thrombocytopenia and hypoalbuminemia were associated with accelerated fibrogenesis. Conclusion Platelet count and albumin levels may serve as potential biomarkers for advanced hepatic fibrosis progression in AIH patients. Dynamic monitoring of these parameters could facilitate early identification of high-risk populations and optimization of individualized therapeutic strategies.

Key words: Autoimmune hepatitis, Advanced hepatic fibrosis, Platelet count, Albumin, Non-invasive biomarkers

Sun Wei, Yu Hong, Dou Jing, Wang Zhuanguo, Ning Zhonghui, Wang Xiaobo, Palida Palahati, Wang Xiaozhong, Guo Feng. An analysis on the predicting factors of progressive liver fibrosis (≥F3) in autoimmune hepatitis patients[J]. Chinese Hepatolgy, 2026, 31(7): 954-957.

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