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Russian Journal of Gastroenterology, Hepatology, Coloproctology

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Diagnosis and Treatment of Patients with Autoimmune Hepatitis (Experts’ Agreement)

https://doi.org/10.22416/1382-4376-2024-34-6-100-119

Abstract

Background. In the last decade, the understanding of the pathogenesis of autoimmune hepatitis (AIH) has significantly deepened, based on the results of new clinical studies some diagnostic issues have been revised and immunosuppressive therapy regimens have been optimized.
Materials and methods. The latest Russian clinical guidelines for the diagnosis and treatment of AIH were presented in 2013; and in 2017, the first Russian agreement on the diagnosis and treatment of AIH was held. Updating approaches to the management of patients with AIH necessitated next systematization for use in clinical practice. In February 2024, the final session was held to discuss the provisions of the second agreement on the diagnosis and treatment of AIH.
Results. This publication presents the main discussion points of the agreement regarding methods and algorithms for detecting autoantibodies, the role of liver biopsy, revised morphological criteria for AIH, optimized immunosuppressive therapy regimens, updated criteria for assessing the response to therapy.
Conclusions. The agreement was the result of the work of a group of experts on the diagnosis and treatment of AIH and represents the basis for the creation of updated federal clinical guidelines.

About the Authors

Yu. G. Sandler
Loginov Moscow Clinical Scientific Center
Russian Federation

Yuliya G. Sandler — Cand. Sci. Med., Senior Researcher of the Department of Hepatology

111123, Moscow, Entuziastov highway, 86 


E. V. Vinnitskaya
Loginov Moscow Clinical Scientific Center
Russian Federation

Elena V. Vinnitskaya — Dr. Sci. (Med.), Head of the Department of Hepatology

111123, Moscow, Entuziastov highway, 86


K. L. Raikhelson
Saint Petersburg State University
Russian Federation

Karina L. Raikhelson — Dr. Sci. (Med.), Professor of the Scientific and Educational Center of Gastroenterology and Hepatology

199226, Saint Petersburg, Korablestroiteley str., 20–1


K. V. Ivashkin
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Konstantin V. Ivashkin — Dr. Sci. Med., Professor of the Department of Propaedeutics of Internal Medicine, Gastroenterology and Hepatology

119435, Moscow, Pogodinskaya str., 1, build. 1


S. N. Batskikh
Loginov Moscow Clinical Scientific Center
Russian Federation

Sergey N. Batskikh — Dr. Sci. (Med.), Leading Researcher of the Department of Hepatology

111123, Moscow, Entuziastov highway, 86


E. N. Aleksandrova
Loginov Moscow Clinical Scientific Center
Russian Federation

Elena N. Aleksandrova — Dr. Sci. (Med.), Head of the Laboratory of Clinical Immunology

111123, Moscow, Entuziastov highway, 86


D. T. Abdurakhmanov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Dzhamal T. Abdurakhmanov — Dr. Sci. (Med.), Professor of the Department of Internal, Occupational Diseases and Pulmonology

119435, Moscow, Pogodinskaya str., 1, build. 1


D. I. Abdulganieva
Kazan State Medical University
Russian Federation

Diana I. Abdulganieva — Dr. Sci. Med., Professor, Head of the Department of Hospital Therapy

420012, Kazan, Butlerova str., 49


I. G. Bakulin
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Igor G. Bakulin — Dr. Sci. (Med.), Professor, Head of the Department of Propaedeutics of Internal Medicine, Gastroenterology and Dietetics named after S.M. Ryss

191015, Saint Petersburg, Kirochnaya str., 41


A. O. Bueverov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Alexey O. Bueverov — Dr. Sci. (Med.), Professor at the Department of Medical and Social Expertise, Emergency and Pathogenetic Therapy

119435, Moscow, Pogodinskaya str., 1, build. 1


S. L. Vorobyev
OOO National Center for Clinical Morphological Diagnostics
Russian Federation

Sergey L. Vorobyev — Cand. Sci. (Med.), Director

192071, Saint Petersburg, Slavy Ave., 32, lit. A


O. A. Gerasimova
Saint Petersburg State University; Russian Scientific Center for Radiology and Surgical Technologies named after Academician A.M. Granov
Russian Federation

Olga A. Gerasimova — Dr. Sci. Med., Professor of the Scientific and Educational Center of Gastroenterology and Hepatology; Head of the Outpatient Center for Transplantology, Hepatology and Nephrology

199226, Saint Petersburg, Korablestroiteley str., 20–1


A. I. Dolgushina
South Ural State Medical University
Russian Federation

Anastasia I. Dolgushina — Dr. Sci. (Med.), Head of the Department of Hospital Therapy

454092, Chelyabinsk, Vorovskogo str., 64


M. S. Zhuravleva
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Mariia S. Zhuravleva — Cand. Sci. (Med.), Associate Professor of the Department of Propaedeutics of Internal Medicine, Gastroenterology and Dietetics named after S.M. Ryss

191015, Saint Petersburg, Kirochnaya str., 41


L. Yu. Ilchenko
N.I. Pirogov Russian National Research Medical University
Russian Federation

Liudmila Yu. Ilchenko — Dr. Sci. (Med.), Professor, Professor of the Department of Hospital Therapy named after Academician G.I. Storozhakov, N.I. Pirogov Russian National Research Medical University

117513, Moscow, Ostrovityanova str., 1


V. E. Karev
Pediatric Research and Clinical Center for Infectious Diseases under the Federal Medical Biological Agency
Russian Federation

Vadim E. Karev — Dr. Sci. (Med.), Head of the Department of Tissue and Pathomorphological Research Methods

197022, Saint Petersburg, Professora Popova str., 9


N. V. Korochanskaya
Kuban State Medical University
Russian Federation

 Natalia V. Korochanskaya — Dr. Sci. (Med.), Professor of the Department of Surgery No. 3 of the Faculty of Advanced Training and Professional Retraining of Specialists

350063, Krasnodar, Mitrofana Sedina str., 4 


I. L. Kliaritskaia
V.I. Vernadsky Crimean Federal University
Russian Federation

Irina L. Kliaritskaia — Dr. Sci. (Med.), Professor, Head of the Department of Therapy, Gastroenterology, Cardiology and General Medical Practice (Family Medicine) of the Fa-culty of Training of Highly Qualified Medical Personnel and Continuing Professional Education of the S.I. Georgievsky Medical Academy

295051, Simferopol, Lenina Blvd, 5/7


N. S. Karnaukhov
Loginov Moscow Clinical Scientific Center
Russian Federation

Nikolay S. Karnaukhov — Cand. Sci. (Med.), Head of the Department of Pathomorphology

111123, Moscow, Entuziastov highway, 86


S. V. Lapin
Academician I.P. Pavlov First St. Petersburg State Medical University
Russian Federation

Sergey V. Lapin — Cand. Sci. (Med.), Head of the Laboratory for Diagnostics of Autoimmune Diseases of the Scientific and Methodological Center for Molecular Medicine of the Ministry of Health of the Russian Federation

197101, Saint Petersburg, L’va Tolstovo str., 6-8


M. A. Livzan
Omsk State Medical University
Russian Federation

Maria A. Livzan — Dr. Sci. (Med.), Corresponding Member of the Russian Academy of Sciences, Professor, Head of the Department of Faculty Therapy and Gastroenterology, Rector

644099, Omsk, Lenina str., 12


M. V. Maevskaya
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Marina V. Maevskaya — Dr. Sci. (Med.), Professor, Consultant at the Diagnostic and Treatment Department of the University Clinical Hospital No. 2

119048, Moscow, Trubetskaya str., 8/2


N. V. Marchenko
Russian Scientific Center for Radiology and Surgical Technologies named after Academician A.M. Granov
Russian Federation

Natalia V. Marchenko — Cand. Sci. Med., Associate Professor of the Scientific and Educational Center of Gastroenterology and Hepatology, Saint Petersburg State University; Gastroenterologist

199226, Saint Petersburg, Korablestroiteley str., 20


T. P. Nekrasova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Tatiyana P. Nekrasova — Cand. Sci. (Med.), Associate Professor at the Institute of Clinical Morphology and Digital Pathology

119435, Moscow, Pogodinskaya str., 1, build. 1


I. G. Nikitin
N.I. Pirogov Russian National Research Medical University
Russian Federation

Igor G. Nikitin — Dr. Sci. (Med.), Professor, Head of the Department of Hospital Therapy No. 2 of the Faculty of Therapy

117513, Moscow, Ostrovityanova str., 1


A. A. Novikov
Loginov Moscow Clinical Scientific Center
Russian Federation

Alexander A. Novikov — Dr. Sci. (Med.), Leading Researcher of the Laboratory of Clinical Immunology

111123, Moscow, Entuziastov highway, 86


R. G. Saifutdinov
Kazan State Medical Academy — Branch Campus of the Russian Medical Academy of Continuous Professional Education
Russian Federation

Rafik G. Saifutdinov — Dr. Sci. (Med.), Head of the Department of Therapy

420012, Kazan, Butlerova str., 36 


E. V. Skazyvaeva
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Ekaterina V. Skazyvaeva — Cand. Sci. (Med.), Associate Professor of the Department of Propaedeutics of Internal Medicine, Gastroenterology and Dietetics named after S.M. Ryss

191015, St. Petersburg, Kirochnaya str., 41


V. E. Syutkin
Medical and Biological University of Innovation and Continuous Education, State Research Center — Byrnasyan Federal Medical Biophysical Center of Federal Biological Agency; N.V. Sklifosovsky Research Institute for Emergency Care of the Moscow City Health Department
Russian Federation

Vladimir E. Syutkin — Dr. Sci. (Med.), Professor of the Department of Surgery with Courses in Oncosurgery, Endoscopy, Surgical Pathology, Clinical Transplantology and Organ Donation; Leading Researcher of the Liver Transplant Department

129010, Moscow, Bolshaya Sukharevskaya sq., 3


M. K. Prashnova
Russian Scientific Center for Radiology and Surgical Technologies named after Academician A.M. Granov
Russian Federation

Mariya K. Prashnova — Cand. Sci. (Med.), Teaching Assistant of the Scientific and Educational Center of Gastroenterology and Hepatology

199226, Saint Petersburg, Korablestroiteley str., 20


T. Yu. Khaymenova
Loginov Moscow Clinical Scientific Center
Russian Federation

Tatyana Yu. Khaymenova — Cand. Sci. (Med.), Head of the Department of Liver Diseases

111123, Moscow, Entuziastov highway, 86


S. G. Khomerik
Loginov Moscow Clinical Scientific Center
Russian Federation

Sergey G. Khomeriki — Dr. Sci. (Med.), Professor, Head of the Pathomorphology Laboratory

111123, Moscow, Entuziastov highway, 86


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Review

For citations:

Sandler Yu.G., Vinnitskaya E.V., Raikhelson K.L., Ivashkin K.V., Batskikh S.N., Aleksandrova E.N., Abdurakhmanov D.T., Abdulganieva D.I., Bakulin I.G., Bueverov A.O., Vorobyev S.L., Gerasimova O.A., Dolgushina A.I., Zhuravleva M.S., Ilchenko L.Yu., Karev V.E., Korochanskaya N.V., Kliaritskaia I.L., Karnaukhov N.S., Lapin S.V., Livzan M.A., Maevskaya M.V., Marchenko N.V., Nekrasova T.P., Nikitin I.G., Novikov A.A., Saifutdinov R.G., Skazyvaeva E.V., Syutkin V.E., Prashnova M.K., Khaymenova T.Yu., Khomerik S.G. Diagnosis and Treatment of Patients with Autoimmune Hepatitis (Experts’ Agreement). Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2024;34(6):100-119. https://doi.org/10.22416/1382-4376-2024-34-6-100-119

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Tatiana L. Lapina - MD, PhD, associate professor, Department of Internal Diseases Propedeutics,
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