AUTOIMMUNE LIVER DISEASE health related quality of life (HRQOL) remained largely stable over a mean follow up of 35.3±23.5 months, with only modest improvements observed in psychological domains, according to longitudinal data from 252 adults with autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis.
Longitudinal HRQOL in Autoimmune Liver Disease
Autoimmune liver disease encompasses autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis, chronic inflammatory disorders characterised by immune mediated liver injury. In this longitudinal study, baseline demographic and clinical characteristics were obtained through medical record review, and HRQOL was assessed using the Chronic Liver Disease Questionnaire.
Participants attended a mean of 4.0±2.2 visits during follow up. Over time, total questionnaire scores increased slightly at approximately 0.02 points per year. Improvements were primarily observed in the emotional and worry domains, while other domains remained unchanged. Overall, HRQOL in autoimmune liver disease appeared relatively stable throughout the observation period. Although the changes were statistically significant, their magnitude was small and should be interpreted cautiously with regard to clinical relevance.
Baseline Factors Associated with HRQOL
Several baseline characteristics were associated with longitudinal differences in health-related quality of life. Female sex was linked to poorer outcomes, whereas male sex was associated with better HRQOL over time.
Coexisting autoimmune disease and Metabolic Associated Steatotic Liver Disease at baseline were both associated with poorer HRQOL trajectories. Ascites at baseline, reflecting hepatic decompensation, was also associated with worse long-term outcomes. In contrast, cirrhosis itself was not significantly associated with HRQOL, suggesting that symptomatic burden rather than fibrosis stage may be more influential. Other comorbidities, including diabetes and coronary artery disease, were not associated with longitudinal HRQOL in this cohort.
Clinical Implications for Autoimmune Liver Disease
These findings indicate that while patients with autoimmune liver disease may experience modest psychological adaptation over time, the broader burden of chronic immune mediated liver disease persists. Subgroups including women and those with coexisting autoimmune conditions, Metabolic Associated Steatotic Liver Disease, or ascites may require closer monitoring and tailored supportive strategies.
The authors conclude that HRQOL in autoimmune liver disease remains relatively stable over time, with small improvements in emotional wellbeing. However, baseline clinical factors play a significant role in shaping long term patient reported outcomes, emphasizing the importance of comprehensive and individualised management.
Reference
Ko D et al. Longitudinal health-related quality of life and associated factors in autoimmune liver diseases. Annals of Hepatology. 2026; DOI:10.1016/j.aohep.2026.102240
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