This retrospective study of a prospectively maintained database evaluated incidence and predictors of hepatic recompensation (by Baveno VII criteria) and further decompensation in 112 patients with AIH-related decompensated cirrhosis treated with immunosuppression, over a median follow-up of 29 months.
54% (60/112) achieved recompensation; biochemical response at 6 months was the strongest predictor (sHR 1.75, 95% CI 1.02–2.88). Recompensated patients had markedly lower mortality (HR 0.22, 95% CI 0.05–0.90) and lower further decompensation rates (15%) vs. non-recompensated patients (69%).
Retrospective single-center design limits generalizability. Median follow-up of only 29 months may underestimate long-term further decompensation rates. Patient consent was waived, and full-text data were not available for deeper subgroup analysis.
Achieving biochemical response by 6 months is the key modifiable target in AIH-related decompensated cirrhosis — it strongly predicts recompensation and a ~78% reduction in mortality risk. Optimize immunosuppression early, especially in younger patients with lower CTP scores.
