What causes autoimmune hepatitis?

We haven’t yet pinpointed the exact cause of autoimmune hepatitis but it appears to be triggered when the genes controlling your immune system are exposed to certain viruses or drugs. 

When this ‘perfect storm’ occurs, your immune system mistakenly attacks your liver.  That can lead to chronic inflammation that damages your liver cells.

Risk factors for autoimmune hepatitis

Autoimmune hepatitis is more likely to develop if you: 

• Are female
• Already have an autoimmune disease like:
  • Type 1 diabetes
  • Coeliac disease
  • Hashimoto’s thyroiditis
  • Graves’ disease
  • Ulcerative colitis
• Have a family history of autoimmune diseases
• Have had an infection like measles, herpes simplex, Epstein-Barr or hepatitis A, B or C.

As you can see there’s a strong link with other autoimmune diseases. Unfortunately, if your immune system has attacked itself once, it’s more likely to do so again. It can go the other way too – about 25-50% of people with AIH go on to develop another autoimmune condition.

Complications of autoimmune hepatitis

Untreated hepatitis may lead to serious complications such as:

• Liver cirrhosis (scarring)
• Liver cancer
• Liver failure.

How is autoimmune hepatitis diagnosed? 

Because many symptoms of autoimmune hepatitis could easily be caused by several other medical conditions, it’s important that you get the right diagnosis. See your GP initially. They may refer you to a doctor who specialises in digestive and liver disorders such as a gastroenterologist or hepatologist. 

Diagnosing autoimmune hepatitis involves gathering ‘clues’ about your liver health and using clinical judgement. 

Those ‘clues’ may come from: 

• Listening to your symptoms and medical history
• A clinical examination
• Blood tests, which may include testing your antibodies for autoimmune hepatitis
• Imaging scans
• A liver biopsy. 

At Moonee Valley Specialist Centre, we’ve chosen a  high-tech, less non-invasive approach to diagnosing autoimmune hepatitis. We use a liver scan called the FibroScan® 502 Touch. This liver scan takes about 10 minutes and enables us to assess whether you have any liver damage. 

The results of this scan, along with your blood tests, symptoms and medical history, enable us to diagnose autoimmune hepatitis and assess its stage. From there, we can make well-informed recommendations for treatment.

Do I need a referral for a liver scan? 

A referral is not essential but it’s usually better.

When your GP refers you, their letter often includes information about your medical history and the results of any recent tests. That’s very helpful to us. A referral also enables us to spend more time with you explaining the results of your Fibroscan and advising on next steps. 

Without a referral, we will only provide a report and you will need to see your doctor to discuss the findings. 

Learn more about our liver scan service.

Autoimmune hepatitis treatment

If you’ve developed autoimmune hepatitis, you’ll need to see a gastroenterologist regularly for many years. You’ll also need regular blood tests or scans to check your liver function and to monitor disease progression. 

The goal of treatment is to slow down or stop your immune system’s attack on your liver. Initially, that usually involves taking a steroid, sometimes with another medication. You may start off on a high dose then reduce the dose over time to avoid side effects, trying to find the lowest dose that still controls your symptoms. 

Some people are able to stop medication eventually because their disease is in remission. Others find they need to keep taking the medication or the condition returns. 

If medication doesn’t succeed in defending your liver or if you develop cirrhosis or liver failure, you may need a liver transplant.