Use of oral vancomycin in children with autoimmune liver disease: A single centre experience

Table 2 Response to medical treatment and outcome of 75 patients with autoimmune liver diseases

Variables	All patients, n = 75	AIH, n = 54	ASC, n = 21	P value
Treatment, n
Prednisone alone	26 (35%)	19 (35%)	7 (33%)	1
Prednisone + Azathioprine	30 (40%)	28 (52%)	2 (10%)	< 0.001
Prednisone + MMF	5 (7%)	3 (5%)	2 (10%)	0.615
Prednisone + Vancomycin	4 (5%)	1 (2%)	3 (14%)	0.064
Prednisone + Azathioprine + Vancomycin	2 (3%)	0 (0%)	2 (10%)	0.075
Prednisone + MMF + Vancomycin	6 (8%)	1 (2%)	5 (23%)	0.005
Prednisone + Tacrolimus	1 (1%)	1 (2%)	0	NA
Cyclosporine	1 (1%)	1 (2%)	0	NA
Response to treatment
Normal AST (NV ≤ 45 U/L): n	69 (92%)	52 (96%)	17 (81%)	0.048
Time to normalize AST (yr)	0.1 (0.1-0.5)	0.2 (0.1-0.6)	0.1 (0.1-0.2)	0.19
GGT (< 50 UI/L), n	68 (91%)	51 (94%)	17 (81%)	0.811
Time to normalize GGT (yr)	0.3 (0.2-0.6)	0.3 (0.2-0.5)	0.3 (0.2-1.1)	0.062
Immunological remission1: n	25 (33%)	22 (40%)	3 (14%)	0.032
Time to immunological remission	3.1 (2.2-4.2)	3.8 (2.9-4.3)	3.4 (3.2-3.7)	0.86
Relapse of AILD during treatment, n
At least one relapse	36 (48%)	22 (41%)	14 (67%)	< 0.070
1 relapse alone	26 (35%)	17 (31%)	9 (43%)	0.421
≥ 2 relapses	10 (13%)	5 (9%)	5 (24%)	0.131
Outcome at last follow up
Median follow up, yr (range)	4.4 (0.6-13.8)	4.1 (1.2-11.7)	4.5 (0.6-13.8)	0.079
Alive	75 (100%)	54 (100%)	21 (100%)	NA
OFF-IS therapy	6 (8%)	5 (9%)	1 (5%)	0.666
Medical treatment	68 (91%)	49 (91%)	19 (90%)	1
Liver transplant	1 (1%)	0 (0%)	1 (5%)	0.28

¹Normal aspartate aminotransferase, normal IgG, and negative or low titer autoantibodies.

AIH: Autoimmune hepatitis; ASC: Autoimmune sclerosing cholangitis; AST: Aspartate aminotransferase; MMF: Mycophenolate mofetil; GGT: Gamma-glutamyl transferase; IS: Immunosuppressive; NA: Not applicable; ALID: Autoimmune liver disease; NV: Normal value.