Auto-immune hepatitis

Auto-immune hepatitis is a rare, serious condition in which the body’s immune system attacks the liver and causes inflammation. It can lead to cirrhosis and liver failure if it isn’t treated. There are two forms of this disease.

Type one (classic) autoimmune hepatitis is the most common form. This mostly affects young women and is often associated with other auto-immune diseases. Type two auto-immune hepatitis is less common and generally affects girls aged between two and 14.

What causes autoimmune hepatitis?

The body’s immune system normally attacks bacteria, viruses and other invading organisms. However, if it attacks the body’s own cells, the response is called autoimmunity. This causes auto-immune hepatitis, which can lead to long-term inflammation and liver damage. A person’s genetic makeup, environmental factors or prior infections can all play a role in causing autoimmune conditions.

What are the symptoms and complications?

Auto-immune hepatitis symptoms are often minor. When symptoms do occur, they commonly include fatigue, abdominal discomfort, aching joints, itching, jaundice and nausea. Other symptoms may include dark urine, loss of appetite, pale stools and absence of menstruation. More severe complications can include abdominal fluid and mental confusion. With proper treatment, it’s possible to enjoy years of remission without symptoms and healthy liver function.

How is autoimmune hepatitis diagnosed?

Auto-immune hepatitis often occurs suddenly. It may initially feel like a mild case of the flu. Primary care doctors use blood tests to accurately diagnose autoimmune hepatitis. A liver biopsy is usually performed after review by hospital specialists. This is when a tiny sample of liver tissue is removed with a needle for examination in a laboratory.

Who is at risk?

Females are at highest risk, particularly those aged between 15 and 40. Many people with this disease also have other autoimmune diseases, including type one diabetes, thyroiditis (inflammation of the thyroid gland), ulcerative colitis (inflammation of the colon), vitiligo (patchy loss of skin pigmentation), or Sjogren’s syndrome (dry eyes and dry mouth).

People with a family history of auto-immune conditions or who have a pre-existing auto-immune disease may be more likely to develop this type of hepatitis.

How can I protect my liver?

It’s important to try to live a healthy lifestyle that helps protect the liver. Eating a healthy, low-fat diet and getting regular exercise are always important. You should also limit your alcohol intake to one drink per day, if at all. If you have experienced significant liver damage, your doctor will likely advise you to abstain from alcohol.

Type one is the most common form of auto-immune hepatitis and mostly affects young women.

How is auto-immune hepatitis treated?

Auto-immune hepatitis can be a lifelong condition and can be acute (short-term) or chronic. People with the condition should work with a doctor to monitor their symptoms and prevent serious complications. With regular check-ups and medication, many people with autoimmune hepatitis can enter remission. Treatment aims to suppress the over-active immune system and stop it from attacking the liver. It may include regular blood tests and frequent doctor visits in the early stages to ensure the body is responding well to treatment.

Treatment should be supervised by a liver health specialist.

In rare, severe situations, acute autoimmune hepatitis may progress to liver failure. Prompt assessment and management by specialists are required. Treatment options for auto-immune hepatitis include corticosteroids and other immunosuppressant medications, as well as a lifestyle that promotes healthy liver function. With early and appropriate treatment, auto-immune hepatitis can usually be controlled.

Chronic inflammation can cause ongoing liver injury over months or years, which may progress to scarring and liver cirrhosis. If not treated effectively, the affected tissue can become scarred and liver function can decline. Lifelong medication use may be required to keep the body’s auto-immune response under control and preserve liver health.

In rare situations, auto-immune inflammation may progress despite medical treatment. If severe liver damage occurs, a liver transplant may be the best option.