revised_original_aih_score: Revised Original Score for Autoimmune Hepatitis (1999)

In cliot: Clinical Indices and Outcomes Tools

Revised Original Score for Autoimmune Hepatitis (1999)

Description

Calculates the 1999 Revised Original Score (International Autoimmune Hepatitis Group) for the diagnosis of Autoimmune Hepatitis (AIH). This comprehensive scoring system evaluates biochemical ratios, autoantibodies, viral markers, histology, and history to classify patients as having Probable or Definite AIH.

Usage

revised_original_aih_score(sex, alp_ast_ratio, globulin_igg_ratio,
                           autoantibody_titer, ama_positive,
                           viral_markers_positive, drug_history_positive,
                           alcohol_intake_low, histology_interface,
                           histology_plasma_cells, histology_rosettes,
                           histology_biliary, other_immune_disease,
                           hla_dr3_dr4, treatment_response = "none")

Arguments

sex	String. "female" (+2 pts) or "male" (0 pts).
alp_ast_ratio	Numeric. Ratio of Alkaline Phosphatase to AST (relative to ULN). (<1.5: +2, 1.5-3.0: 0, >3.0: -2).
globulin_igg_ratio	Numeric. Ratio of Serum Globulins (or IgG) to the Upper Limit of Normal. (>2.0: +3, 1.5-2.0: +2, 1.0-1.5: +1, <1.0: 0).
autoantibody_titer	String. Titer of ANA, SMA, or Anti-LKM1. Options: "gt_1_80" (>1:80, +3), "1_80" (1:80, +2), "1_40" (1:40, +1), "lt_1_40" (<1:40, 0).
ama_positive	Numeric (0 or 1). Antimitochondrial Antibody positive? (1 = Yes, -4 pts).
viral_markers_positive	Numeric (0 or 1). Positive markers for active Hepatitis A, B, or C? (1 = Yes, -3 pts; 0 = No, +3 pts).
drug_history_positive	Numeric (0 or 1). History of hepatotoxic drug use? (1 = Yes, -4 pts; 0 = No, +1 pt).
alcohol_intake_low	Numeric (0 or 1). Average alcohol intake < 25 g/day? (1 = Yes, +2 pts; 0 = No, -2 pts).
histology_interface	Numeric (0 or 1). Interface hepatitis (piecemeal necrosis)? (1 = Yes, +3 pts).
histology_plasma_cells	Numeric (0 or 1). Predominantly lymphoplasmacytic infiltrate? (1 = Yes, +1 pt).
histology_rosettes	Numeric (0 or 1). Liver cell rosettes? (1 = Yes, +1 pt).
histology_biliary	Numeric (0 or 1). Biliary changes? (1 = Yes, -3 pts). (Note: If histology "None of above" is present, that is -5 pts, usually captured by entering 0 for all specific positives).
other_immune_disease	Numeric (0 or 1). Presence of other autoimmune diseases? (1 = Yes, +2 pts).
hla_dr3_dr4	Numeric (0 or 1). HLA DR3 or DR4 present? (1 = Yes, +1 pt).
treatment_response	String. Response to therapy (optional for pre-treatment score). "none" (0), "complete" (remission, +2), "relapse" (relapse after cessation, +3).

Value

A list containing:

AIH_Score	The calculated total score.
Diagnosis	Diagnostic classification (Definite >15, Probable 10-15, Unlikely <10).

References

Alvarez F, Berg PA, Bianchi FB, et al. International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol. 1999;31(5):929-938. doi:10.1016/s0168-8278(99)80297-9

Examples

# Example 1: Definite AIH
# Female (+2), Low ALP ratio (+2), High IgG (+3), ANA 1:160 (+3), No viral/drugs/alcohol (+3+1+2)
# Interface (+3), Plasma (+1)
# Score = 2+2+3+3+3+1+2+3+1 = 20
revised_original_aih_score("female", 1.0, 2.5, "gt_1_80", 0, 0, 0, 1, 1, 1, 0, 0, 0, 0)

# Example 2: AIH Unlikely
# Male (0), Viral Pos (-3), Alcohol High (-2), Histology Biliary (-3)
# Score = -8 + baseline factors
revised_original_aih_score("male", 2.0, 1.0, "lt_1_40", 0, 1, 0, 0, 0, 0, 0, 1, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.