AASLD PRACTICE GUIDELINES Diagnosis and Treatment of Autoimmune Hepatitis

These guidelines provide a data-supported approach to the diagnosis and management of patients with autoimmune hepatitis. They are based on the following: (1) a formal review and analysis of the published world literature on autoimmune hepatitis (914 articles) (Medline Search from 1966-2002; the search term was autoimmune hepatitis); (2) recommendations developed and published by the International Autoimmune Hepatitis Group; (3) concepts developed at the AASLD Single Topic Conference on autoimmune hepatitis in September 1999; and (4) 40 years of combined experience by both authors in the clinical and laboratory investigation and care for patients with this disease. The guidelines, intended for use by physicians, are meant to be flexible, in contrast to “standards of care,” which are inflexible policies to be followed in almost every case. They have been developed in a manner consistent with the American Association for the Study of Liver Diseases’ Policy Statement on Development and Use of Practice Guidelines. Specific recommendations are based on relevant published information. In an attempt to standardize recommendations, the Practice Guidelines Committee of the American Association for the Study of Liver Diseases modified the categories of the Infectious Diseases Society of America’s Quality Standards. These categories are reported with each recommendation, using the Roman numerals I through IV to determine the quality of evidence upon which the recommendations are based. The categories are as follows: I, evidence from multiple well-designed randomized controlled trials, each involving a number of participants to be of sufficient statistical power; II, evidence from at least one large, well-designed clinical trial with or without randomization, from cohort or case-control analytic studies, or from well-designed meta-analysis; III, evidence based on clinical experience, descriptive studies, or reports of expert committees; and IV, not rated.