Autoimmune hepatitis

J Hepatol. 2011 Jul;55(1):171-82. doi: 10.1016/j.jhep.2010.12.012. Epub 2010 Dec 15.


Autoimmune hepatitis was one of the first liver diseases for which an effective treatment was developed and the benefit proven by randomized controlled trials. Nonetheless, both the diagnosis and the treatment of autoimmune hepatitis remain full of challenges. The clinical spectrum is very wide, ranging from subclinical non-progressive disease to fulminant hepatic failure. Diagnostic criteria based on elevation of IgG, demonstration of characteristic autoantibodies, and histological features of hepatitis in the absence of viral disease are very helpful. However, in some patients, diagnosis remains a clinical challenge. Adequately dosed steroids are the mainstay of remission induction treatment, while remission maintenance is best achieved by azathioprine. Therapeutic alternatives are required in a small group of patients responding insufficiently to these drugs or intolerant to their side effects.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Azathioprine / therapeutic use
  • Carcinoma, Hepatocellular / etiology
  • Clinical Trials as Topic
  • Female
  • Hepatitis, Autoimmune / diagnosis*
  • Hepatitis, Autoimmune / drug therapy*
  • Hepatitis, Autoimmune / immunology
  • Hepatitis, Autoimmune / therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Liver Neoplasms / etiology
  • Liver Transplantation
  • Male
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / drug therapy
  • Risk Factors
  • Steroids / therapeutic use
  • Treatment Outcome


  • Immunosuppressive Agents
  • Steroids
  • Azathioprine