Autoimmune Hepatitis

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Autoimmune hepatitis is a chronic disease in which your immune system attacks your liver. While the condition can be controlled with medication, autoimmune hepatitis that has progressed or is diagnosed at later stages can lead to liver failure. Severe autoimmune hepatitis may require advanced treatments, including a liver transplant. Duke hepatologists are experts in treating autoimmune hepatitis. We help you manage your condition, monitor its progression, and prepare you for a liver transplant if it becomes necessary.

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About Autoimmune Hepatitis

More Common in Women
While the cause of autoimmune hepatitis is unclear, the condition is known to occur more often in women and to run in families. It is more commonly found in people with other autoimmune conditions, such as rheumatoid arthritis, thyroid disease or inflammatory bowel disease.

Seek Care If You Have Autoimmune Hepatitis Symptoms
Some people with autoimmune hepatitis do not have any symptoms. Others may have joint pain, skin rashes, nausea, poor appetite, and fatigue. If you have these symptoms and your liver tests are abnormal, it’s important to seek medical care with a hepatologist as soon as possible. Liver specialists at Duke will diagnose your condition and start treatment promptly. This will minimize your symptoms and keep your liver as healthy as possible. Most people with autoimmune hepatitis do well and never need a liver transplant.

Why Early Diagnosis and Expert Treatment Are Important
Left untreated, inflammation caused by autoimmune hepatitis can result in permanent scarring of your liver, called cirrhosis. Liver cancer, liver failure, and other serious complications may also occur. Early diagnosis and treatment can prevent these problems. 

Treatment for Complications
If autoimmune hepatitis leads to cirrhosis and other health problems, our hepatologist will work with other specialists to recommend the most effective treatment for your condition.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Tests

If autoimmune hepatitis is suspected, your hepatologist will conduct an extensive medical history and physical exam. One or more of the following tests may be prescribed to confirm your diagnosis or to evaluate whether your condition has progressed.

Blood Tests

Lab work can measure levels of specific liver enzymes that may indicate if you have autoimmune hepatitis, viral hepatitis, an inherited liver disorder, or potentially fatty disease related alcohol consumption or to metabolic issues like obesity. These tests can also check for antibodies that are often abnormal in people with autoimmune hepatitis. 

Ultrasound, CT, MRI

These imaging tests can help diagnose complications that can result from autoimmune hepatitis.

Biopsy

A small piece of liver tissue is removed using a thin needle inserted through the abdomen. A biopsy can show the extent of liver scarring and help confirm the diagnosis of autoimmune hepatitis, as well as guide treatment decisions.

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Treatments

Autoimmune hepatitis can range from mild to severe. Your Duke hepatologist will consider all aspects of your condition and recommend one of these treatments:

Immunosuppressants

Corticosteroids (prednisone or prednisolone) can slow and often stop your immune system’s attack on your liver. These drugs are frequently used in combination with other immunosuppressants such as azathioprine, mycophenolate, tacrolimus, or cyclosporine in order to minimize side effects and maximize effectiveness. An effective drug regimen can relieve symptoms and commonly leads to a remission, in which symptoms disappear and tests of liver inflammation normalize. Liver damage may be reversed. 

Treatment with immunosuppressants requires ongoing management by a hepatologist, who will monitor your medication levels and ensure you don’t have a relapse after your condition improves. Your hepatologist will also work to minimize the doses of medication needed to keep your liver healthy.

Liver Transplantation

Most people with autoimmune hepatitis do well with medication. However, if you have liver failure or liver cancer, you may be evaluated for a liver transplant. A transplant involves removing your diseased liver and replacing it with a healthy organ. If you are recommended for transplant, you will work with our experienced transplant team and receive comprehensive, personalized care -- before, during, and after your surgery.

Best Hospital for Gastroenterology and GI Surgery in NC

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our gastroenterology and GI surgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

Why Choose Duke

Extensive Experience, Individualized Treatment
Our liver specialists have extensive experience treating people with autoimmune hepatitis and other liver conditions. We offer the most advanced treatments and individualize your treatment to ensure you experience the best possible outcome.

A Team of Liver Specialists
Your team will include a range of specialists who work together to give you the highest level of care. Our hepatologists, surgeons, nutritionists, social workers, transplant coordinators, and others design a care plan that considers not just your physical condition but also your emotional and psychological wellbeing.

Families Welcome
We understand the important role family and friends play in helping you through this journey. With your approval, we include your family as part of your care team and keep them up to date on your condition and treatments.

If You Need a Liver Transplant
Duke’s adult liver transplant outcomes are among the nation’s best. We have the experience and resources to offer hope to people who need a liver transplant who have been turned down by other centers. We work closely with cardiologists, infectious disease doctors, and pulmonologists who specialize in evaluating patients for liver transplantation. 

This page was medically reviewed on 10/16/2023 by