In addition, there are five private specialist clinics that provide hepatology services to the region. The population-based AIH cohort was recruited and validated with methods described in detail in our earlier studies.1, 11 In brief, cases were recruited both prospectively and retrospectively using multiple

case-finding strategies. All private and public gastroenterology clinic notes, inpatient discharge BTK inhibitor datasheet codes, laboratory, pathology, and radiology reports were searched to identify retrospectively all known cases of AIH in Canterbury diagnosed from January 1, 1980 to December 31, 2006. All gastroenterologists who serve the region also provided a list of their patients with these diseases. From 2007 to 2011, cases were recruited prospectively. Demographic, clinical data, laboratory, radiology, and histology results selleck chemicals were extracted from paper and computer case notes. Cases were included in the study if they had definite or probable AIH as determined using the revised original scoring system.12 All patients were tested for hepatitis C infection. Potential cases with uncertain hepatitis C status were excluded

from the study (a total of 12 patients were excluded for this reason). The date of diagnosis was taken as the date that the liver biopsy was performed. Patients who did not undergo a liver biopsy or had follow-up of less than 6 months were excluded from this study. MCE公司 End of follow-up was at death, liver transplantation, last outpatient clinic consultation for those that were lost to follow-up, or the end of study (December 31, 2011). There were minor differences in the characteristics of the study cohort compared to earlier studies, as this study included patients diagnosed in 2011 and had excluded patients without a liver biopsy. This study received ethical approval from the Upper South A Regional Ethics Committee. Baseline factors that were evaluated in this study include gender, age, serological markers, immunoglobulin G (IgG), bilirubin, liver enzymes, platelet

count, albumin, INR at presentation, and histological fibrosis stage at diagnosis. Stages of fibrosis were evaluated using the Metavir scoring system. Advanced liver fibrosis was defined as Metavir stages 3 and 4, and histological cirrhosis was defined as Metavir stage 4. Age at presentation was categorized into four groups: group 1 (ages 0-20 years), group 2 (ages 21-40 years), group 3 (ages 41-60 years), and group 4 (ages over 60 years). The ULN range of our laboratory for alanine aminotransferase (ALT) is 30 U/L. For this study, pretreatment ALT levels were also categorized into four groups: group A (<90 U/L), group B (91-150 U/L), group C (151-300 U/L), and group D (>300 U/L). Response to initial immunosuppression was defined as normal ALT at 6 months from diagnosis, as it had been reported that the majority of AIH patients would respond to treatment within 3-6 months.