Диагностика и лечение пациентов с аутоиммунным гепатитом (соглашение специалистов)

Введение. В последнее десятилетие существенно углубилось понимание патогенеза аутоиммунного гепатита (АИГ), пересмотрены некоторые вопросы диагностики, на основании результатов новых клинических исследований оптимизированы схемы иммуносупрессивной терапии.
Материалы и методы. Последние Российские клинические рекомендации по диагностике и лечению АИГ были представлены в 2013 г. В 2017 г. было создано первое Российское соглашение по вопросам диагностики и лечения АИГ. Обновление подходов к ведению пациентов с АИГ обусловило необходимость очередной систематизации для применения в клинической практике. В феврале 2024 г. состоялась заключительная сессия по обсуждению положений второго соглашения по диагностике и лечению АИГ.
Результаты. В настоящей публикации представлены основные положения соглашения, касающиеся методов и алгоритмов выявления аутоантител, роли биопсии печени, пересмотренных морфологических критериев АИГ, оптимизированных схем иммуносупрессивной терапии, а также обновленных критериев оценки ответа на терапию.
Выводы. Соглашение стало итогом работы группы российских экспертов по диагностике и лечению АИГ и представляет собой основу для создания обновленных федеральных клинических рекомендаций.

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