Autoimmune Hepatitis Questions & Answers

Updated: Jun 11, 2019
  • Author: David C Wolf, MD, FACP, FACG, AGAF, FAASLD; Chief Editor: BS Anand, MD  more...
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Questions & Answers

Overview

What is autoimmune hepatitis (AIH)?

What are the possible presentations of autoimmune hepatitis (AIH)?

What are the signs and symptoms of autoimmune hepatitis (AIH)?

What are the common symptoms of autoimmune hepatitis (AIH)?

Which physical findings suggest autoimmune hepatitis (AIH)?

What is the prevalence of common autoimmune hepatitis (AIH) symptoms in children?

Which lab findings are characteristic of autoimmune hepatitis (AIH)?

Which hematologic abnormalities suggest autoimmune hepatitis (AIH)?

What is the role of liver biopsy in autoimmune hepatitis (AIH)?

What is the role of corticosteroids in the treatment of autoimmune hepatitis (AIH)?

What is the likelihood of relapse in patients with autoimmune hepatitis (AIH)?

When is liver transplantation indicated for treatment of autoimmune hepatitis (AIH)?

What is autoimmune hepatitis (AIH)?

What is included in the workup of autoimmune hepatitis (AIH)?

What are the treatment options for autoimmune hepatitis (AIH)?

Where can patient education be obtained for autoimmune hepatitis (AIH)?

What are the CDC risk-based testing guidelines for autoimmune hepatitis (AIH)?

What are the characteristics of chronic autoimmune hepatitis (AIH) in young women?

What is the role of systemic lupus erythematosus (SLE) in the pathogenesis of autoimmune hepatitis (AIH)?

What is the importance of viral serologic tests in the diagnosis of autoimmune hepatitis (AIH)?

What is autoimmune hepatitis (AIH)?

How has the histopathologic description and diagnostic criteria evolved for autoimmune hepatitis (AIH)?

What is the pathogenesis of autoimmune hepatitis (AIH)?

What is the role of genetics in the pathogenesis of autoimmune hepatitis (AIH)?

What is the role of T lymphocytes in the pathogenesis of autoimmune hepatitis (AIH)?

What is the role of complement allele C4AQO in the pathogenesis of autoimmune hepatitis (AIH)?

Which viruses may trigger autoimmune hepatitis (AIH)?

Which drugs are known to trigger autoimmune hepatitis (AIH)?

What causes liver injury in the pathophysiology of autoimmune hepatitis (AIH)?

What is the role of antigen presenting cells (APCs) in the pathogenesis of autoimmune hepatitis (AIH)?

What are the reasons for the aberrant HLA display in autoimmune hepatitis (AIH)?

What is the role of helper T cells 1(TH 1s) and helper T cells 2 (TH 2s) in the pathogenesis of autoimmune hepatitis (AIH)?

What is the role of liver cells in the pathogenesis of autoimmune hepatitis (AIH)?

What is the evidence for an autoimmune pathogenesis of autoimmune hepatitis (AIH)?

Which autoantibodies are present in autoimmune hepatitis (AIH)?

What are the clinical characteristics of autoimmune hepatitis (AIH)?

What is the etiology of autoimmune hepatitis (AIH)?

Which clinical conditions may lead to autoimmune hepatitis (AIH)?

Which drugs are known to trigger autoimmune hepatitis (AIH)?

What is the prevalence of Helicobacter species in autoimmune hepatitis (AIH)?

What is the prevalence of autoimmune hepatitis (AIH) in the US?

What is the global prevalence of autoimmune hepatitis (AIH)?

What is the ratio of the global incidence of AIH-1 to AIH-2 autoimmune hepatitis (AIH)?

How does the incidence of autoimmune hepatitis (AIH) vary by race?

How does the incidence of autoimmune hepatitis (AIH) vary by sex?

How does the incidence of autoimmune hepatitis (AIH) vary by age?

What is the prognosis of autoimmune hepatitis (AIH)?

What are the mortality risk factors of autoimmune hepatitis (AIH)?

What is the role of immunosuppressive therapy in the management of autoimmune hepatitis (AIH)?

What is the duration of treatment for autoimmune hepatitis (AIH)?

How does HLA status affect the treatment outcome for autoimmune hepatitis (AIH)?

What is the likelihood of spontaneous resolution of autoimmune hepatitis (AIH)?

Which patient groups have a worse prognosis of autoimmune hepatitis (AIH)?

How common is hepatocellular carcinoma (HCC) in patients with autoimmune hepatitis (AIH)?

Which factors are associated with a worse prognosis for autoimmune hepatitis (AIH)?

Presentation

What are the clinical features of autoimmune hepatitis (AIH)?

What are the possible presentations of autoimmune hepatitis (AIH)?

How frequently does autoimmune hepatitis (AIH) have an acute hepatitis presentation?

What are the signs and symptoms of autoimmune hepatitis (AIH)?

When should subclinical autoimmune hepatitis (AIH) be considered?

What are the initial signs of autoimmune hepatitis (AIH)?

When is systemic involvement likely in autoimmune hepatitis (AIH)?

What are the hematologic symptoms of autoimmune hepatitis (AIH)?

What are the GI symptoms of autoimmune hepatitis (AIH)?

What are rheumatologic complications of autoimmune hepatitis (AIH)?

Which conditions may be comorbid with autoimmune hepatitis (AIH)?

What was the basis of the Gregorio et al study of autoimmune hepatitis types 1 and 2 (AIH-1 and AIH 2)?

What is the prevalence of comorbid autoimmune disorders in children with autoimmune hepatitis (AIH)?

What were the clinical findings and their corresponding prevalence of the 2005 Oettinger study of 142 children with autoimmune hepatitis (AIH)?

Which autoimmune disorders are comorbidities of autoimmune hepatitis type 1 (AIH-1)?

Which autoimmune disorders are comorbid with autoimmune hepatitis type 2 (AIH-2)?

Which physical findings are characteristic of autoimmune hepatitis (AIH)?

What are the complications of autoimmune hepatitis (AIH)?

DDX

What is the danger of a missed diagnosis of autoimmune hepatitis (AIH)?

What is the danger to a wrong diagnosis of autoimmune hepatitis (AIH)?

How likely is autoimmune hepatitis (AIH) to become chronic?

Which chronic liver diseases should be included in the differential diagnosis of autoimmune hepatitis (AIH)?

Which autoimmune disorders should be included in the differential diagnoses of autoimmune hepatitis (AIH)?

What is the role of hepatitis C virus (HCV) in the etiology of autoimmune hepatitis (AIH)?

What is the significance of a false-positive result for hepatitis C virus (HCV) in the evaluation of autoimmune hepatitis (AIH)?

What is the role of anti–smooth muscle antibody (ASMA) and antinuclear antibody (ANA) in the diagnosis of autoimmune hepatitis (AIH)?

How is chronic hepatitis C (HCV) differentiated from autoimmune hepatitis (AIH)?

What liver disorders have symptoms that overlap with autoimmune hepatitis (AIH)?

What is autoimmune hepatitis–PBC overlap syndrome?

What is autoimmune hepatitis–PSC overlap syndrome?

How is autoimmune cholangitis differentiated from autoimmune hepatitis (AIH)?

What is cryptogenic autoimmune hepatitis (AIH?

What are the differential diagnoses for Autoimmune Hepatitis?

Workup

Which tests are performed in the workup of autoimmune hepatitis (AIH)?

What is the role of liver biopsy in the diagnosis of autoimmune hepatitis (AIH)?

Which lab findings are characteristic of autoimmune hepatitis (AIH)?

How frequently are liver function test results abnormal in patients with autoimmune hepatitis (AIH)?

What are the CDC screening guidelines for hepatitis C virus (HCV)?

Which findings on autoantibody tests are diagnostic of autoimmune hepatitis (AIH)?

What is the role of smooth-muscle antibodies (SMAs) testing in the diagnosis of autoimmune hepatitis (AIH)?

What is the role of liver-kidney microsomal type 1 (LKM-1) testing in the diagnosis of autoimmune hepatitis (AIH)?

Which autoantibodies may be present in the evaluation of autoimmune hepatitis (AIH)?

What the role of immunoglobulin testing in the evaluations of autoimmune hepatitis (AIH)?

What is the importance of gamma globulin or immunoglobulin G (IgG) in the management of autoimmune hepatitis (AIH)?

What is a common immunoglobulin finding in patients with autoimmune hepatitis type 2 (AIH-2)?

What is the role of serum aminotransferases measurement in the diagnosis of autoimmune hepatitis (AIH)?

What does continued elevation of aminotransferase levels indicate in autoimmune hepatitis (AIH)?

Once liver functions are normal, what is included in the management of autoimmune hepatitis (AIH)?

What is the role of liver chemistries in the workup of autoimmune hepatitis (AIH)?

What hematologic lab findings suggest autoimmune hepatitis (AIH)?

What is the role of imaging studies in the diagnosis of autoimmune hepatitis (AIH)?

What are the benefits to using imaging studies in the diagnosis of autoimmune hepatitis (AIH)?

When is endoscopic retrograde cholangiopancreatography (ERCP) indicated in the diagnosis of autoimmune hepatitis (AIH)?

How is liver biopsy performed for the diagnosis of autoimmune hepatitis (AIH)?

When is liver biopsy indicated for the diagnosis of autoimmune hepatitis (AIH)?

What is the role of liver biopsy in patients with established cirrhosis due to autoimmune hepatitis (AIH)?

What is the role of histopathologic findings in the diagnosis of autoimmune hepatitis (AIH)?

What histologic findings are characteristic of autoimmune hepatitis (AIH)?

What can biopsies reveal about autoimmune hepatitis (AIH)?

How does a finding of cirrhosis affect the prognosis of autoimmune hepatitis (AIH)?

What is the significance of a finding of fibrosis in autoimmune hepatitis (AIH)?

When is the International autoimmune hepatitis (AIH) Group scoring system used?

What is the significance of a histopathologic finding of multinucleated giant hepatocytes in the evaluation of autoimmune hepatitis (AIH)?

Which histologic finding may help distinguish autoimmune hepatitis (AIH) from other forms of chronic hepatitis?

Treatment

What are the mainstay of drug therapy for autoimmune hepatitis (AIH)?

Why is thiopurine methyltransferase (TPMT) genotyping performed prior to azathioprine therapy for autoimmune hepatitis (AIH)?

How do the treatment options differ between symptomatic and asymptomatic autoimmune hepatitis (AIH)?

What are the AASLD treatment guidelines for autoimmune hepatitis (AIH) in adults?

When is treatment indicated for autoimmune hepatitis (AIH)?

What are the AASLD recommendations for initial treatment regimens for autoimmune hepatitis (AIH)?

What are the British Society of Gastroenterology (BSG) treatment guidelines for autoimmune hepatitis (AIH)?

When is maintenance therapy considered in treatment of autoimmune hepatitis (AIH)?

What are the AASLD guidelines for initial regimens for treatment of autoimmune hepatitis (AIH) in children?

What is the role of prednisolone in the treatment of autoimmune hepatitis (AIH)?

When are liver enzyme levels checked during the treatment of autoimmune hepatitis (AIH)?

When is azathioprine indicated in the treatment of autoimmune hepatitis (AIH)?

What is the role of budesonide in the treatment of autoimmune hepatitis (AIH)?

What is the role of cyclosporine in the treatment of autoimmune hepatitis (AIH)?

What are the possible endpoints in the treatment of autoimmune hepatitis (AIH)?

How is remission indicated in autoimmune hepatitis (AIH)?

How is remission achieved in acute liver failure from autoimmune hepatitis (AIH)?

What is the duration of therapy for autoimmune hepatitis (AIH)?

What is the time difference between histologic remission and clinical and lab remission in autoimmune hepatitis (AIH)?

How is treatment failure for autoimmune hepatitis (AIH) defined?

When is liver transplantation considered in autoimmune hepatitis (AIH)?

What are the treatment options for autoimmune hepatitis (AIH) if standard therapy fails?

What is the role of tacrolimus therapy in the treatment of autoimmune hepatitis (AIH)?

What is the role of mycophenolate mofetil in the treatment of autoimmune hepatitis (AIH)?

What is the efficacy of mycophenolate mofetil in the treatment of autoimmune hepatitis (AIH)?

What is the role of budesonide in the treatment of autoimmune hepatitis (AIH)?

How is incomplete response in the treatment of autoimmune hepatitis (AIH) defined?

What is the goal of therapy for autoimmune hepatitis (AIH) after an incomplete response to treatment?

When should patients with autoimmune hepatitis (AIH) be considered for liver transplantation?

How is drug toxicity managed during the treatment of autoimmune hepatitis (AIH)?

What are the signs and symptoms of drug toxicity during the treatment of autoimmune hepatitis (AIH)?

What is the role of azathioprine in the treatment of autoimmune hepatitis (AIH)?

What is the role of vitamins C and D during the treatment of autoimmune hepatitis (AIH)?

What are complications of azathioprine therapy for autoimmune hepatitis (AIH)?

What is the efficacy of azathioprine in the treatment of autoimmune hepatitis (AIH)?

What is the teratogenicity of azathioprine therapy for autoimmune hepatitis (AIH)?

How do the BSG and AASLD recommendations differ regarding the treatment of autoimmune hepatitis (AIH) during pregnancy?

Which treatments for autoimmune hepatitis (AIH) increase the risk for hematologic malignancy?

What is the prevalence of relapse in patients treated for autoimmune hepatitis (AIH)?

How are recurrent relapses of autoimmune hepatitis (AIH) treated?

What are the dangers of premature withdrawal of drug therapy for autoimmune hepatitis (AIH)?

What is the efficacy of liver transplantation in patients with autoimmune hepatitis (AIH)?

Why does recurrence of autoimmune hepatitis (AIH) occur after liver transplantation?

What are the risk factors associated with recurrence of autoimmune hepatitis (AIH) after liver transplantation?

What are the treatment options for autoimmune hepatitis (AIH)-primary biliary cirrhosis (PBC) overlap syndrome?

What diet modifications may be needed during treatment of autoimmune hepatitis (AIH)?

When are activity restrictions indicated during the treatment of autoimmune hepatitis (AIH)?

What long term monitoring is needed for the management of autoimmune hepatitis (AIH)?

Medications

Which medications are used in the treatment of autoimmune hepatitis (AIH)?

Which medications in the drug class Immunosuppressant agents are used in the treatment of Autoimmune Hepatitis?

Which medications in the drug class Corticosteroids are used in the treatment of Autoimmune Hepatitis?