Abstract: Objective The aim of this study was to investigate impacting factors of poor response to immunosuppressive therapy in patients with autoimmune hepatitis (AIH). Methods 57 patients with AIH were enrolled in this study between January 2022 and June 2023, and all received liver biopsies. All patients were treated by prednisone or prednisone with combination of azathioprine. Blood biochemical indexes and immunoglobulin levels were routinely detected. Serum autoimmune antibodies were assayed by Western blot. Impacting factors of response was analyzed by multivariate Logistic regression. Results By end of one-year treatment, the complete response (CR) rate to immunosuppressive therapy in the 57 patients with AIH was 75.4%; ages, percentages of liver cirrhosis, ascites and Child-Pugh score in patients with partial response (PR) were 57(44, 62)yr, 64.3%, 42.8% and 10(8, 12)points, all significantly greater or higher than [53(41, 60)yr, 18.6%, 11.6% and 6(5, 8)points, respectively, P<0.05] in those with CR; PLT counts and serum albumin level in patients with PR were 81(67,105)×10⁹/L and 32.3(30.0, 36.7)g/L, both significantly lower than [131(96, 210)×10⁹/L and 36.8(34.5, 39.5)g/L, respectively, P<0.05], while total serum bilirubin (TSB) level, international normalized ratio of prothrombin time, serum IgM and IgG levels in patients with PR were 56.9(30.1, 132.5)μmol/L,1.3(1.1, 1.6),14.0(12.3, 16.7)g/L and 17.7(14.5, 19.4)g/L, all much higher than [34.3(16.7, 67.9)μmol/L, 1.1(1.0, 1.2),11.2(9.4, 13.2)g/L and 12.5(10.7, 14.6)g/L, respectively, P<0.05] in those with CR; there were no significant differences as respect to interfacial hepatitis, Rosette-like manifestations, plasma cell infiltration and bile duct damages between the two groups (P>0.05);multivariate Logistic regression analysis showed that liver cirrhosis (OR=6.283, 95%CI:1.728-10.769,P=0.002), TSB (OR=11.158, 95%CI:2.200-18.758, P=0.001) and serum IgG level (OR=16.894, 95%CI:4.118-30.018, P<0.001) were the independent factors impacting response to immunosuppressive therapy. Conclusion Clinicians should take some impacting factors into consideration when immunosuppressive therapy is administered in patients with AIH, and optimization of treatment might carry out as necessary as possible.

Key words: Autoimmune hepatitis, Prednisone, Therapy, Response, Impacting factors