AI Summary The Lille score shows whether corticosteroids are working in severe alcohol-associated hepatitis. Doctors calculate it from blood tests after about 7 days of treatment. A score below 0.45 suggests a response, so the planned course may continue. A score of 0.45 or higher suggests non-response, and steroids should stop to avoid risks. A few carefully selected non-responders may be considered for early transplant evaluation. The score does not diagnose AH or replace other scores, and stopping alcohol remains essential.
Source: www.liverdirectory.com
Medically Reviewed.
The Lille score is a calculated number that shows how well your liver is responding to corticosteroid treatment for severe alcohol-associated hepatitis. Doctors usually work it out after about 7 days of treatment.
A score below 0.45 points to a response. A score of 0.45 or higher means steroids are not helping enough, and your care team may change the plan. Below, you will find what the score means, how it compares with similar scores, and questions to bring to your visit.
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LILLE MODEL BASICS
The Lille score is a calculated result that checks how well a person with severe alcohol-associated hepatitis (AH) responds to corticosteroids. AH, also called alcoholic hepatitis, is liver inflammation linked to heavy drinking.
Your care team calculates the score from blood test results. Guidelines say to assess treatment response with the Lille score, typically after 7 days of therapy. Response must be checked at day seven.
A higher score means a poorer response and a poorer outlook. That helps your doctors decide whether to keep going with steroids or try another approach.
The Lille score does not diagnose AH, and it does not show how severe the disease was at the start. Other scores, such as the Maddrey Discriminant Function, do that. The Lille score answers a different question: is treatment working?
STEROID RESPONSE TIMING
The score has one job: to judge response to steroid treatment. It applies to a narrow group of people.
Guidance recommends corticosteroids for severe AH, typically a Maddrey DF of 32 or higher or a high MELD score, when no contraindication is present. The Lille score comes after that decision, as a check on how treatment is going.
Response is typically assessed after 7 days of therapy. A standard course of prednisolone lasts about 28 days, so the day-7 result helps decide whether the rest of the course is worthwhile.
Corticosteroids weaken immune defenses and raise the risk of infection, gastrointestinal bleeding, and metabolic problems. They do not reverse cirrhosis. The Lille score helps avoid these risks in people who are not benefiting.
For people who do not respond, the score can prompt a discussion about other care, including early liver transplant evaluation at a transplant center.
LILLE SCORE 0.45 CUTOFF
Guidelines use one cutoff: 0.45. Your doctor interprets your number alongside your symptoms, lab trends, and overall health.
The cutoff is 0.45. Below it suggests a response; at or above it suggests the steroids are not working.
Keep in mind: A high score does not mean treatment options have run out. It means steroids are not the right tool, and your team will look at other care.
ALCOHOLIC HEPATITIS SCORE COMPARISON
These scores answer different questions. Doctors often use more than one.
| Score | What it tells you | Typical timing | Cutoff used in practice |
|---|---|---|---|
| Lille score | Whether steroid treatment is working | About day 7 of therapy | 0.45 or higher means non-response |
| Maddrey Discriminant Function | How severe AH is, using prothrombin time and bilirubin | Before treatment | 32 or higher suggests severe AH |
| MELD score | How severe liver disease is, and risk of short-term death | Before treatment and over time | A high MELD supports steroid use; 15 or higher suggests transplant benefit |
The Glasgow Alcoholic Hepatitis Score and ABIC score are also prognostic scores for AH. See the group page for an overview.
AFTER YOUR LILLE RESULT
Your result is one piece of your care plan. These steps help you use it well.
Stopping alcohol completely is essential for liver recovery, whatever your score shows.
Download Free Liver Test Patient GuideLearn about treatment options for liver disease, including care for alcohol-associated hepatitis, and questions to bring to your care team.
Explore Liver TreatmentA balanced, liver-friendly diet supports your liver, helps manage weight and blood sugar, and lowers the risk of other health problems during long-term follow-up.
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COMMON QUESTIONS
The Lille score is a calculated result that shows whether a person with severe alcohol-associated hepatitis (AH) is responding to corticosteroids. Your care team works it out from blood test results, typically after 7 days of treatment. A higher score means a poorer response and a poorer outlook. The score does not diagnose AH, and it does not show how severe the disease was at the start. It answers one question: is treatment working?
A score below 0.45 is the better result. It suggests your liver is responding to steroids, and your care team may continue the planned course. A score of 0.45 or higher means the steroids are not working well enough. Guidelines call this a non-response and say therapy should be discontinued. A response is not a cure, and stopping alcohol remains essential. Your doctor reads your number alongside your symptoms, lab trends, and overall health.
Doctors typically check it after 7 days of steroid therapy. Response must be checked at day seven. A standard course of prednisolone lasts about 28 days, so the day-7 result helps decide whether the rest of the course is worthwhile. This early check lets the team stop steroids sooner in people who are not benefiting. That avoids risks such as infection, stomach or bowel bleeding, and metabolic problems.
No. A high score means steroids are not the right treatment for you. It does not mean care has run out. Your team may stop the steroids and review other care. A small, carefully selected group of non-responders may be considered for early liver transplant evaluation, before six months of abstinence. Relapse rates in these recipients were similar to those transplanted after a required abstinence period. Ask your care team whether this could apply to you.
No. The two scores answer different questions. The Maddrey Discriminant Function combines prothrombin time and bilirubin to rate how severe alcohol-associated hepatitis is. Guidance uses it, typically a score of 32 or higher, to help decide who gets steroids. The Lille score comes afterward. It checks how well the steroids worked. Doctors often use more than one score.
Medical disclaimer: LiverDirectory provides educational information and a directory of providers. It does not provide medical advice, diagnosis, or treatment. Always consult a licensed physician regarding any medical condition.
