Patients with latent AIP
Approximately 80% of heterozygotes remain asymptomatic and never become ill.  For these carriers, precautions to avoid harmful factors are advised. Knowledge that they are carriers enables prompt diagnosis and treatment if porphyric symptoms develop.
Patients with clinically expressed AIP
The mortality from acute attacks is low, and most patients will recover completely, especially if the diagnosis and treatment are prompt. Advanced motor neuropathy may recover completely over months or several years, but there may be residual weakness or neuropathic pain.
Most patients who develop symptoms have only a single attack or a few attacks during their lifetime. However, a few patients have many attacks even if they avoid harmful factors. Dietary consultation is recommended to detect unapparent dietary indiscretions. Those who respond to preventive interventions, such as a gonadotropin-releasing hormone (GnRH) analog for frequent cyclic attacks confined to the luteal phase of the cycle,  or prophylactic hemin administration weekly or biweekly for noncyclic attacks,  may also have a good prognosis. Some patients with frequent attacks develop chronic, unremitting symptoms.
Neuropathic pain becomes chronic in a few patients, especially after many acute exacerbations. These patients may require long-term pain management, including narcotic analgesics. They are prone to depression and suicide, and should be actively managed to prevent such outcomes. 
Patients with AIP should be evaluated at least yearly.
Urinary porphobilinogen (PBG) should be followed and may have prognostic value.
Hypertension should be controlled, and renal and hepatic function followed.
Chronic, mild increases in ALT are common, but the risk of cirrhosis is not known to be increased.
Liver imaging is recommended at least yearly after age 50 years in patients who have a history of symptoms, especially if urinary PBG remains elevated, for early detection of hepatocellular carcinoma.
Patients are instructed to inform their physician if they have latent or clinically expressed AIP. They should maintain copies of medical records and laboratory reports that document the diagnosis, and provide them to physicians when needed. They should be familiar with harmful and safe drugs, and have access to recommended websites with pertinent information. http://www.porphyriafoundation.com [American Porphyria Foundation] http://www.porphyria-europe.com [European Porphyria Network] A medical alert bracelet may be worn, but any warnings should not preclude use of drugs that may be life-saving under emergency conditions. Follow-up with a physician and screening for renal impairment and early hepatocellular carcinoma are recommended.