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Comparative Hepatitis pp 217–228Cite as

Autoimmune hepatitis in humans

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Part of the book series: Birkhäuser Advances in Infectious Diseases ((BAID))

Abstract

Autoimmune hepatitis (AIH) can occur in all age groups from earliest childhood up until the 8th decade. AIH affects women more commonly than men (3:1). Clinical presentation may be an acute hepatitis up to fulminant liver failure, but can also be asymptomatic.

AIH is characterised by lympho-plasmacellular infiltrates on liver biopsy, elevated liver enzymes in serum and association with the HLA haplotypes B8, DR3 and DR4 in the absence of active viral markers. Patients characteristically present with hypergammaglobulinemia, elevated serum levels of IgG and autoantibodies, such as antinuclear antibodies (ANA), smooth muscle antibodies (SMA), antibodies to soluble liver antigen/ liver pancreas (SLA/LP) or to liver-kidney microsomes (LKM).

Corticosteroids are the drug of choice for remission induction, azathioprine the drug of choice for maintenance of remission. The rapid response to immunosuppressive treatment supports the diagnosis of AIH and leads to a good long-term prognosis. Treatment duration remains controversial and can be discussed after resolution of all clinical, laboratory and histological manifestations of disease activity. Treatment should be maintained for a minimum of 3 years.

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Authors and Affiliations

  1. Department of Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 24046, Hamburg, Germany

    Stefan Lüth & Ansgar W. Lohse

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  1. Stefan Lüth
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  2. Ansgar W. Lohse
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Editors and Affiliations

  1. Bayer AG, 51368, Leverkusen, Germany

    Olaf Weber

  2. Institute of Virology, Technical University Munich/Helmholtz Center Munich, Trogerstr. 30, 81675, München, Germany

    Ulrike Protzer

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Lüth, S., Lohse, A.W. (2008). Autoimmune hepatitis in humans. In: Weber, O., Protzer, U. (eds) Comparative Hepatitis. Birkhäuser Advances in Infectious Diseases. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-8558-3_10

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