Autoimmune Hepatitis | Liver Disease

Liver Disease

Autoimmune Hepatitis

Our program provides the full range of care for autoimmune hepatitis. We offer the latest treatments to help you achieve remission, including clinical trials.

Medically reviewed by Christopher Bowlus, M.D. on Dec. 12, 2023.

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Dedicated Team to Treat Autoimmune Hepatitis

At UC Davis Health, our team helps people with autoimmune hepatitis live healthy, active lives. We focus on preventing or healing liver damage with science-backed treatments and the latest clinical trials.

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What Is Autoimmune Hepatitis?

Autoimmune hepatitis (AIH) happens when your immune system attacks your liver cells. Normally, your immune system targets invaders like viruses, bacteria and even cancer cells. If you have an autoimmune condition, your immune system mistakenly attacks healthy cells in your body.

In autoimmune hepatitis, the immune response attacks the main cells in the liver called hepatocytes leading to inflammation of the liver, called hepatitis (liver inflammation). This is similar to the inflammation that can occur with viral hepatitis, but in this case, there is no infection.

Without treatment, AIH can cause fibrosis or scarring in the liver leading to cirrhosis, the most severe form of liver fibrosis and liver failure. Fortunately, AIH is very treatable, and most patients do not progress, though they often require lifelong treatment and monitoring.

AIH is frequently classified as type 1 or type 2 AIH. Type 1 accounts for 90% of all AIH cases and usually occurs in adults. Type 2 often occurs in children and accounts for the other 10% of cases.

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Symptoms of Autoimmune Hepatitis

You may not have symptoms in the early stages of AIH. If symptoms do occur, they are frequently no specific and include fatigue and weight loss. In some cases, symptoms don’t show up until liver damage has occurred.

Common Symptoms

Symptoms of AIH are different for everyone. You may experience:

  • Fatigue
  • Dark urine
  • Nausea or lack of appetite
  • Pain in your upper right abdomen
  • Trouble sleeping

Emergency Symptoms

AIH can be severe. Seek emergency medical care if you experience:

  • Confusion or trouble thinking
  • Fluid in your abdomen
  • Jaundice (yellowing of the eyes or skin)
  • Pale-colored stool
  • Vomiting blood
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What Causes Autoimmune Hepatitis?

Autoimmune hepatitis occurs when your immune system mistakenly attacks your liver’s cells. Experts aren’t sure what causes this immune system reaction. However, research has uncovered some possible causes, including:

Genes

Studies have identified some specific genes (inherited traits) that could play a role in whether you develop AIH.

Environment

Viruses, medications and chemicals have been suggested to lead to AIH if you also have the genes that make you more prone to developing it.

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Risk Factors for Autoimmune Hepatitis

Autoimmune hepatitis is rare, but it seems to affect people with these risk factors:

Female Sex

Being born female is the main risk factor for AIH. Autoimmune hepatitis affects 4 times more females than males.

Family History

If your parent or sibling has autoimmune hepatitis, you have a higher risk of developing it. A family history of other autoimmune conditions, such as type 1 diabetes, could also raise your risk.

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Diagnosing Autoimmune Hepatitis

There’s no single test that can identify AIH. A skilled gastroenterologist (digestive system specialist) or hepatologist (liver specialist) diagnoses this condition by looking at several factors and ruling out other conditions.

Our specialists have years of experience treating liver diseases and rare genetic conditions. With our expertise, you can be confident you’ll receive a detailed, accurate diagnosis and a clear path forward.

We start by taking your family health history, including any history of autoimmune disease. We also discuss your symptoms, other health conditions and any medications or supplements you take. Then, we order blood tests to check your liver function and the presence of autoantibodies, which often occur with autoimmune conditions. A liver biopsy is usually required to make the diagnosis of AIH.

Treatments for Autoimmune Hepatitis at UC Davis Health

Treatment usually involves suppressing (calming) the abnormal immune response that causes AIH. The right treatment can relieve symptoms and prevent liver damage. Your liver may also be able to repair itself from previous damage.

At UC Davis Health, you receive a customized treatment plan and ongoing care and support. We regularly monitor you to ensure your treatment is working, and we aim to achieve remission and improve any symptoms you may be experiencing.

Our physicians are also involved in clinical trials. We’re actively seeking new treatments for this disease that can benefit people now and for years to come. We may offer opportunities for you to try these new therapies before they’re widely available.

Corticosteroids

Our team often begins AIH treatment with corticosteroids. These medications calm inflammation in the liver and prevent further damage. We monitor you for side effects at every step of treatment.

Immunosuppressants

Immunosuppressants are medications that lower your body’s immune response. These medications may allow us to eventually lower or eliminate your corticosteroid medication.

Liver Transplant

With the right treatment, most people with AIH never need a liver transplant. But if your liver damage is severe or medications don’t work for you, a transplant may be an option.

Learn more about liver transplants

"Diagnosis," Autoimmune Hepatitis Association, https://aihep.org/diagnosis/

"Autoimmune Hepatitis," National Organization for Rare Disorders, https://rarediseases.org/rare-diseases/autoimmune-hepatitis/

AIH affects

4XMore females than males

Up to

50%Of people with AIH will develop another autoimmune condition

How effective is AIH treatment?

93%Of people have healthy liver enzymes after 12 months of treatment

Sources: National Organization of Rare Disorders: Autoimmune Hepatitis 

Journal of Gastroenterology: Long-Term Outcomes of Patients with Autoimmune Hepatitis Managed at a Nontransplant Center

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