Chronic auto-immune hepatitis requires lifelong maintenance therapy in the majority of patients. Relapse is almost universal when therapy is withdrawn. Besides minimizing the risk of disease relapse and or progression, long-term treatment goals in AIH are to minimize side effects of treatment such as bone loss, diabetes and obesity with prednisolone and marrow depression, hepatotoxicity and a possible increased risk for malignancy with thiopurines. Long term thiopurine monotherapy is generally safe and well tolerated in AIH patients, but in general practice, in most patients use a combination of low dose prednisone and azathioprine for many years3, 4 to their satisfaction. It is unclear if there is a difference in relapse rate, progression of disease, quality of life and/or side effects between low dose combination therapy and thiopurine monotherapy. Seela et al in 2005 reported on a group of AIH patients on long term therapy for AIH, but only 3 out of the forty-two patients in their cohort were on thiopurine monotherapy, making it difficult to compare the difference in clinical outcome. In this study we compare two age and sex matched groups of AIH patients using monotherapy or low dose combination therapy to evaluate difference in clinical outcome after five and ten years of follow-up.
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