What is Autoimmune Hepatitis (AIH)?
AIH is a rare condition where an individual's immune system attacks its own liver cells. This leads to inflammation in the liver, and then potentially scarring to the liver known as fibrosis.
Who typically gets AIH?
AIH tends to occur in more females than males, but the exact reasons for development are not fully understood. AIH is an autoimmune condition, and therefore genetics most likely plays an important role in its development. There is particular focus on an area of your genetic material that is known as the ‘Human Leukocyte Antigen’ (HLA) region. Every cell in the body has a tag which identifies it as your own cell, and errors in the production and presentation of these tags (called MHCs) are a key reason for the body to attack its own cells.
What are the symptoms of AIH?
AIH leads to damage of the liver and so may cause fatigue, itching, muscle pains, abdominal pain and general malaise/sickness. You may also develop jaundice, a yellowing of the skin.
It is common, though not universal, for individual with AIH to have other autoimmune conditions such as pernicious anaemia which leads to B12 deficiency and coeliac disease, an autoimmune reaction to the consumption of gluten.
How is AIH diagnosed?
AIH is usually first suspected after abnormal blood tests. This can come in two forms. Firstly, blood markers for autoimmune function may be raised, i.e IgG (Immunoglobulin G), ANA (Antinuclear Antibody), SMA (anti-smooth muscle antibody). This list is not an exhaustive one of blood markers for the immune system, and there may be other markers your doctor monitors for diagnosis and management.
Secondly, a liver function blood test (LFT) will look at indicators of liver health like AST and ALT. You may also receive an imaging test like an ultrasound or an MRI to assess the health of your liver. However, AIH is currently always diagnosed via biopsy. Your doctor will use a combination of these blood tests, imaging tests and biopsy to assess what management and treatment regime is required.
What is the treatment for AIH?
Treatment aims to reduce autoimmune activity by reducing inflammation with immunosuppressant and steroid treatment. Azathioprine is usually taken in some dosage to reduce the immunes activity and so reduce attacks on the liver cells. Steroids budesonide or prednisolone are also often taken in conjunction, acting to reduce inflammation and immune system function.
Treatment for AIH can have some side effects, and so your medical team will closely monitor your blood and biopsy test results to see how you are responding to treatment, aiming to vary your dosage in response to this. Healthy lifestyle recommendations will also be made.
Are there any AIH support groups I can contact?
AIH Support UK offer a website full of general information and support structures for sufferers of AIH.