Autoimmune hepatitis is a disease in which the immune system damages the liver cells. This leads to increasing scarring within the liver and eventually cirrhosis. This process takes approximately 20 years.
Autoimmune hepatitis is not contagious. Patients inherit a genetic tendency to develop this disease and many persons with autoimmune hepatitis have family members with other immune disorders. Patients with autoimmune hepatitis frequently have other immune disorders as well. The most common of these is Rheumatoid Arthritis.
Many persons with autoimmune hepatitis are asymptomatic. However, when the disorder is severe patients may develop severe muscle and joint aches, fatigue and jaundice.
Autoimmune hepatitis causes the blood liver enzyme tests to be abnormal. A specific antibody is also present in the blood of many but not all patients with autoimmune hepatitis.
The treatment for autoimmune hepatitis is to suppress the immune system and prevent it from damaging the liver. Effective treatment causes the liver enzymes to decline back to the normal range. In many cases this is associated with resolution of all liver injury and return of the liver to normal. However, about 20% of persons with autoimmune hepatitis continue to have progressive liver injury but at a much slower rate than they would have without treatment. Although autoimmune hepatitis will sometimes resolve and treatment can be discontinued most patients with autoimmune hepatitis will relapse if treatment is stopped and have to remain on immune suppressive therapy their entire life.
The most common medication utilized for treatment of autoimmune hepatitis is prednisone. Although prednisone is highly effective in treating this liver disease it has many side effects. Prednisone can cause diabetes, weight gain, stomach ulcers, increase the risk for infections and cataracts. For these reasons many alternative medications which suppress the immune system are utilized.
Dr. Shiffman and his team at the Liver Institute of Virginia have extensive experience in managing patients with autoimmune hepatitis. Dr. Shiffman directed several clinical trials over the past several years to develop alternative treatments for autoimmune hepatitis so patients would not have to remain on prednisone and develop the side effects of these medications. Patients suspected of having autoimmune hepatitis should be evaluated by the team at the Liver Institute of Virginia and discuss treatment options for this disease.