Autoimmune Hepatitis: Your Questions Answered

Dr. Michell Shiffman of Bon Secours' Liver Institute of Virginia

Dr. Michell Shiffman of Bon Secours' Liver Institute of Virginia

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.

+ Learn about The Liver Institute of Virginia
+ Find out about the clinical trials at the Liver Institute of Virginia
+ Read more articles about Liver Health

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About Dr.MLShiffman

Dr. Mitchell Shiffman is the Bon Secours expert on liver disease and liver treatments for Virginia. Prior to joining Bon Secours, Dr. Shiffman was a professor of Medicine at Virginia Commonwealth University (VCU) in Richmond, VA. He was the Chief of the Hepatology Section and Medical Director of the Liver Transplant Program at the VCU Medical Center from 1989 until 2009. During his 20 years at the VCU Medical Center Dr. Shiffman built and directed one of the most respected and productive hepatology programs in the United States. Dr. Shiffman is recognized as one of the world’s leaders in the field of Hepatology. His particular area of research is viral hepatitis. He has been involved with and/or directed numerous clinical trials to develop new and better treatments for viral hepatitis B and C. Dr. Shiffman is a regular speaker on the treatment of viral hepatitis, the management of various liver disorders, and issues related to liver transplantation at regional, national and international society meetings. He has published over 200 articles in medical journals related to the treatment of liver diseases and has edited two books on this topic. In addition, he has contributed to various HCV educational resources including an HCV educational kit. Dr. Shiffman is also a widely recognized expert consultant to pharmaceutical companies on the treatment of liver disease. Dr. Shiffman holds a Bachelor of Arts from State University of New York at Buffalo, a Master of Science in physiology from the University of New Mexico School of Medicine in Albuquerque, N.M. and his Doctor of Medicine from State University of New York Upstate Medical Center in Syracuse, N.Y. He completed his internship and residency in internal medicine and fellowship training in gastroenterology and hepatology at the Medical College of Virginia Hospitals in Richmond, VA. Dr. Shiffman is a member of many professional organizations including: the American College of Gastroenterology, American College of Physicians, the American Gastroenterological Association, American Society for the Study of Liver Diseases, American Society of Transplantation, European Association for the Study of the Liver, International Liver Transplantation Society, Richmond Academy of Medicine, Virginia Medical Society and the Virginia Gastrointestinal Society. He was a member of the Board of Trustees with the American College of Gastroenterology from 2003-2009.

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