Six (7,5%) presented histological criteria compatible to acute AIH and 72 (90%) had a diagnosis of chronic hepatitis. Eight patients were not submitted to liver biopsy. Comparative analysis revealed a trend to higher average ALT levels in “genuine” acute AIH (29±11 vs 20±12 xULN; p=0,06). No difference was found regarding levels of AST, bilirubin, alkaline phosphatase, GGT and gamaglobulin levels, as well as ANA and SMA titers. Prothrombin activity was higher in “genuine” acute patients (93±10%
vs 66±21%;p<0,001), as well as albumin levels (3,9 ±0,2 g/dL vs 3,4 ±0,5 g/dL; p<0,001). Biochemical Ibrutinib supplier response to treatment was achieved in all cases of “genuine” acute HAI (100%) vs 71% of acute-on-chronic patients (p=0,03) Conclusion: Acute presentation of AIH was common (61%) in our series. However, “genuine” acute AIH was not a frequent finding (7,5% of all acute presentation cases). “Genuine” acute AIH presented with more preserved liver function tests, suggesting that most
cases presenting with loss of function are acute-on-chronic AIH. Lastly, “genuine” acute AIH revealed a better biochemical response to treatment, suggesting that a more preserved liver function at presentation has a positive therapeutic implication. Disclosures: The following people have nothing to disclose: Elze M. Oliveira, Ana Cristina Nutlin-3a clinical trial A. Feldner, Patricia M. Oliveira, Valéria P. Lanzoni, Renata M. Perez, Antonio Eduardo B. Silva, Maria Lucia Ferraz Background: Treatment of autoimmune hepatitis (AIH) with conventional immunosuppression is effective in preventing hepatic failure in most patients. However, up to 40% of patients present with advanced liver disease and are at risk for poor outcomes. The rate of biochemical response and its impact on outcomes among those with advanced disease is unknown. Aim: To MCE examine the relationship between biochemical response and outcomes in AIH patients with advanced liver disease. Methods: 242 patients with AIH were identified from outpatient visits at our tertiary referral center from 2000 to 2013. Study inclusion required treatment with immunosuppression and clinical follow-up of at least 6 months
including laboratory examination. Advanced disease was defined by biopsy (Lud-wig stage III or IV) or by clinical, endoscopic or radiographic findings consistent with cirrhosis. Biochemical response was defined according to clinical practice guidelines (normal serum AST or ALT, and bilirubin within one year of treatment start or 50% improvement of all liver tests during the first month of treatment, with AST or ALT levels less than twice the upper normal limit within 6 months). Those who did not meet these criteria were considered non-responders. Continuous variables were summarized using medians and 25th and 75th percentiles, and P values obtained with the Wilcoxon rank sum test. Categorical variables were compared using the Chi-squared test.