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Is Autoimmune Hepatitis Curable?

Autoimmune hepatitis, a disorder characterized by the inflammation of the liver, occurs in 100,000 to 200,000 people annually. Researchers have determined that between 10 and 24 of every 100,000 people in northern Europe have autoimmune hepatitis. While there is no cure for the disorder, autoimmune hepatitis treatment can help manage the disease by limiting the damage done to the liver.

What is Autoimmune Hepatitis?

Autoimmune hepatitis (AIH), also known as autoimmune chronic hepatitis, is an autoimmune disease. In any autoimmune disorder, the body’s immune system attacks its cells, and in this case, the liver cells. AIH is chronic because it lasts for more than six months, usually many years, and if left untreated, can lead to liver cirrhosis or failure.

Hepatitis

Hepatitis is a term generally used to describe swelling or inflammation of the liver. The liver is one of the vital organs in the body that serves many functions. The liver:

  • Filters out the blood from intoxicants
  • Controls blood levels
  • Produces bile, proteins, and fats
  • Removes bacteria from the blood to fight off infections
  • It also regulates blood clotting

The liver does a lot to ensure that the body remains healthy. If it becomes inflamed, a lot of bodily functions are deranged.

Types of Autoimmune Hepatitis

There are two main types of autoimmune hepatitis.

  • Type 1 AIH is the most common type of AIH and can occur in people of any age or sex.
  • Type 2 AIH is less common and mostly occurs in younger women and females,
  • Infrequent forms of AIH that feature symptoms of AIH and other liver diseases occur in at least 15% of people suffering from AIH.

Symptoms

Something about AIH that is worrisome is that in the early stages, patients may not feel the symptoms of the disease. It usually gets detected when the patient gets tested for something else, for example, a health check-up for an insurance company.

The most frequently occurring symptom of AIH is fatigue. You feel tired all the time. Other symptoms may appear suddenly and may even take a few weeks or months to become noticeable. These include:

  • Belly pain
  • Fever
  • The eyes and skin become yellow (jaundice)

You may also experience the following symptoms eventually:

  • Pain in the muscles or joints
  • Loss of weight
  • A decreased appetite.
  • Skin problems such as rashes or acne
  • Problems of the stomach, such as vomiting, feeling nauseous, or having belly pain
  • Dark yellow urine
  • The menstrual cycle becomes imbalanced
  • Lack of menstrual period
  • Gallstones
  • Problems of the brain, such as hepatic encephalopathy

Autoimmune Specialist

Causes

While it remains unclear as to what exactly causes AIH, the following factors may trigger the autoimmune system to attack itself:

  • Environmental factors such as viruses, medication, or toxins
  • Inheriting genes that easily trigger the disease, known as genetic predisposition

Diagnosis

For the diagnosis of AIH, your doctor will inquire about any symptoms you might have experienced, your rate of alcohol consumption, and any medication you have been using. Since symptoms of AIH do not appear immediately, the doctor may carry out a blood test to check the levels of antibodies in the blood and rule out whether you have an autoimmune disease. In a biopsy, lab specialists study a small portion of the liver cells using a microscope to rule out the disease.

Treatment

There is no specific cure for autoimmune hepatitis. However, through autoimmune hepatitis treatment, you may manage the disorder and limit the damage done to the liver.

The main goal of autoimmune hepatitis treatment is to suppress the immune system, so it may stop attacking the liver cells and reduce swelling of the liver.

How the patient pursues treatment depends upon the discretion of the autoimmune hepatitis specialist. The doctor will monitor your lab results, and if symptoms and lab results get worse, sign you up for autoimmune hepatitis treatment.

Medications

Prednisone, a steroid medicine, is given to patients to tone down the swelling of the liver and avoid scarring of the liver tissue. However, prednisone may show severe side effects such as:

  • Acne
  • Increased blood sugar levels
  • Increase in weight
  • Increased blood pressure
  • Disturbance in sleep
  • Loss of weight
  • Greater risk of infections

To reduce the side effects of prednisone, the patient is given small doses of the steroid and carefully monitored by the autoimmune hepatitis specialist. Other forms of the steroid include prednisolone and budesonide.

Additionally, the doctor may prescribe azathioprine (or mercaptopurine) to the patient to lessen the side effects caused by prednisone. However, the drug increases the risk of some cancers, lower white blood count, leads to an inflamed pancreas and causes nausea.

Tacrolimus or cyclosporine, are anti-rejection medicine, is given if the patient does not respond to the initial treatment.

Liver Transplant

If the symptoms of the disease worsen or liver cirrhosis occurs, the patient may have to consider undergoing a liver transplant. In most cases of a liver transplant, a liver from a deceased organ donor gets used. In the case of a live liver transplant, only a portion of the liver of a living donor gets transplanted into the patient as liver cells (in both the livers) grow back immediately.

No Medication

In some cases, the doctor does not assign medication to the patient initially and monitors the progress of the disease. At this time, follow-ups are carried out, and the patient should ensure he does the following:

  • Avoid alcohol. The liver breaks down alcohol and people suffering from AIH have an already damaged liver, so to prevent further damage; they should avoid all types of alcohol, wine, beer, and liquors.
  • Maintain a healthy lifestyle by having a balanced diet and exercising. Obesity may complicate the symptoms of AIH as it can cause fatty liver disease, so a healthy lifestyle can help prevent that.

Autoimmune Hepatitis Remission

Autoimmune hepatitis remission means that the severity of AIH symptoms has reduced. It also means that biopsy reports show improved conditions in the appearance of the liver tissue and liver blood tests depicting normal or close to normal ranges.

Therefore, doctors continue with autoimmune hepatitis treatment until the patient reaches the state of autoimmune hepatitis remission or the opposite happens, i.e., treatment fails to improve liver health or the patient experiences drastic side effects. It usually takes up to 12 months for the patient to go into remission, and on average, people reach remission within 18 to 36 months of treatment.

However, that is not the end. While some people stay in remission and only experience mild symptoms of AIH reappearance after autoimmune hepatitis treatment is over, around 75% of people enter a state of relapse, in which the AIH symptoms begin to appear again. Relapse usually occurs within the first six or twelve months after treatment.

See Also: Alpha-Gal Allergy Treatment

Conclusion

Autoimmune hepatitis is a condition that may go undiagnosed, and even if it gets diagnosed, there is no specific cure for it. The only way to maintain a healthy lifestyle while having the disease is to manage it via autoimmune hepatitis treatment.  Our autoimmune hepatitis specialists at Family Medicine Austin are well-trained to diagnose the disorder. We also offer screening tests that help detect the disease so you may pursue treatment at the earliest.

We also prescribe medications such as immunosuppressive drugs like corticosteroids to manage the damage done by the disease and other pain-relieving medicines to fight the symptoms caused by autoimmune hepatitis.

Family Medicine Austin

Written by Jeannette

I am Jeannette, the medical writing specialist here at Family Medicine Austin. I have over five years of experience working with a range of medical and healthcare across the U.S.