Abstract: Objective The aim of this study was to investigate diagnostic performance of four noninvasive indexes in predicting liver cirrhosis (LC) in patients with autoimmune liver diseases (AILDs). Methods 130 patients with AILDs, including autoimmune hepatitis (AIH) in 93 cases and autoimmune hepatitis-primary biliary cholangitis overlap syndrome (AIH-PBC OS) in 37 cases, were encountered in our hospital between April 2017 and September 2020, and all underwent liver biopsies. Aspartate aminotransferase to platelet ratio index (APRI), fibrosis index based on the four factors (FIB-4), aspartate aminotransferase to alanine aminotransferase ratio (AAR) and liver stiffness measurement (LSM) were routinely obtained. Diagnostic efficacy was assessed by area under receiver operating characteristic curve (AUROC). Results Liver histopathological examination showed LC in 21 patients (22.6%) from AIH and 6 patients (16.2%) from AIH-PBC OS; no matter in patients with AIH or with AIH-PBC OS, LSM, FIB-4 and AAR in patients with LC were significantly higher than in those without (P＜0.05); the AUCs were 0.876, 0.783 and 0.745 in predicting LC in patients with AIH, when LSM, FIB-4 and AAR greater than 17.7 kPa, 3.6 and 1.1 were set as the cut-off-values, and the AUCs were 0.989, 0.914 and 0.833 in predicting LC in patients with AIH-PBC OS, when LSM, FIB-4 and AAR greater than 22.9 kPa, 7.7 and 1.0 were set as the cut-off-values. Conclusion Noninvasive LSM, FIB-4 and AAR could predict LC in patients with AILDs, which might be helpful for screening and early diagnosis.

Key words: Autoimmune liver diseases, Autoimmune hepatitis, Autoimmune hepatitis-primary biliary cholangitis overlap syndrome, Liver cirrhosis, Diagnosis