P-126 INTERPHASE HEPATITIS IN PRIMARY BILIARY CHOLANGITIS, SEVERITY FACTOR AND NO RESPONSE TO URSODEOXICOLIC ACID?

Introduction

Primary biliary cholangitis (PBC) is a chronic cholestatic disease that can progress to cirrhosis. The presence of fibrosis represents a predictive factor of progression and failure of response to ursodeoxycholic acid (UDCA). Currently, liver biopsy is not required for its diagnosis, however the finding of interface hepatitis (IH) in the histology could have a prognostic role.

Objectives

To compare in patients with biopsied PBC the presence of fibrosis and response to UDCA (Barcelona, ​​Mayo II and Paris II criteria) according to the presence or absence of IH.

Methods

Histological findings and clinical characteristics of patients with biopsied PBC were retrospectively analyzed, at the stage when it was necessary for the diagnosis or in case of subsequent diagnostic doubt, between 2013-2019. Patients meeting the Paris criteria for PBC/HAI overlap were excluded.

Results

36 patients were identified: 94% women, mean age 53 years (32-68), ANA (+) in 77%, elevated IgG in 58%. 11/36 with HI on biopsy. IH was associated with a greater presence of fibrosis (73% vs 36%; p <0.05) and higher ANA titers > 1/640 (50% vs 17%). In 24 patients, annual response to UDCA could be evaluated: 45% of the patients with IH met at least 2 response criteria vs 69% of the group without histological IH.

Conclusion

The presence of IH in PBC is associated with greater fibrosis and worse biochemical response. Liver biopsy may be necessary in patients who do not respond to UDCA due to suspected interface activity.