This type of hepatitis occurs when your immune system attacks your liver with destructive antibodies. Immune-suppressing medication is the main treatment.
Autoimmune hepatitis is liver inflammation that occurs when your body's immune system turns against liver cells. The exact cause of autoimmune hepatitis is unclear, but genetic and enviromental factors appear to interact over time in triggering the disease.
Untreated autoimmune hepatitis can lead to scarring of the liver (cirrhosis) and eventually to liver failure. When diagnosed and treated early, however, autoimmune hepatitis often can be controlled with drugs that suppress the immune system.
A liver transplant may be an option when autoimmune hepatitis doesn't respond to drug treatments or in cases of advanced liver disease.
Signs and symptoms of autoimmune hepatitis vary from person to person and may come on suddenly. Some people have few, if any, recognized problems in the early stages of the disease, whereas others experience signs and symptoms that may include:
Make an appointment with your doctor if you have any signs or symptoms that worry you.
Autoimmune hepatitis occurs when the body's immune system, which ordinarily attacks viruses, bacteria and other pathogens, instead targets the liver. This attack on your liver can lead to chronic inflammation and serious damage to liver cells. Just why the body turns against itself is unclear, but researchers think autoimmune hepatitis could be caused by the interaction of genes controlling immune system function and exposure to particular viruses or drugs.
Doctors have identified two main forms of autoimmune hepatitis.
Factors that may increase your risk of autoimmune hepatitis include:
Autoimmune hepatitis that goes untreated can cause permanent scarring of the liver tissue (cirrhosis). Complications of cirrhosis include:
Esophageal varices are enlarged veins in the esophagus. They're often due to blocked blood flow through the portal vein. The portal vein carries blood from the intestine, pancreas and spleen to the liver.
Tests and procedures used to diagnose autoimmune hepatitis include:
A liver biopsy is a procedure to remove a small sample of liver tissue for laboratory testing. Liver biopsy is commonly performed by inserting a thin needle through your skin and into your liver.
Regardless of which type of autoimmune hepatitis you have, the goal of treatment is to slow or stop the immune system attack on your liver. This may help slow the progression of the disease. To meet this goal, you'll need medications that lower immune system activity. The initial treatment is usually prednisone. A second medication, azathioprine (Azasan, Imuran), may be recommended in addition to prednisone.
Prednisone, especially when taken long term, can cause a wide range of serious side effects, including diabetes, thinning bones (osteoporosis), broken bones (osteonecrosis), high blood pressure, cataracts, glaucoma and weight gain.
Doctors typically prescribe prednisone at a high dose for about the first month of treatment. Then, to reduce the risk of side effects, they gradually reduce the dose over the next several months until reaching the lowest possible dose that controls the disease. Adding azathioprine also helps you avoid prednisone side effects.
Although you may experience remission a few years after starting treatment, the disease often returns if the drug is discontinued. Depending on your situation, you may require lifelong treatment.
When medications don't halt the progress of the disease or you develop irreversible scarring (cirrhosis) or liver failure, the remaining option is a liver transplant.
During a liver transplant, your diseased liver is removed and replaced with a healthy liver from a donor. Liver transplants most often use livers from deceased organ donors. In some cases, a living-donor liver transplant can be used. During a living-donor liver transplant, you receive only a portion of a healthy liver from a living donor. Both livers begin regenerating new cells almost immediately.
If you have any signs or symptoms that worry you, start by making an appointment with your primary care doctor. If your doctor suspects you may have autoimmune hepatitis, you may be referred to a specialist in liver diseases (hepatologist).
Because appointments can be brief and there's often a lot to discuss, it's a good idea to be prepared for your appointment. Here's some information to help you get ready and know what to expect from your doctor.
For autoimmune hepatitis, some basic questions to ask your doctor include:
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask: