Autoimmune Hepatitis (AIH)

What is the illness?

Description

It is a chronic inflammation of the liver which, if not recognised and treated, may lead to cirrhosis and hepatic insufficiency.

Spread

It is considered a rare disease. There are no epidemiological data for Switzerland; it is estimated that there are about 1500 persons affected by autoimmune hepatitis in Switzerland. 4 out of 5 patients are women. All ages, including children, are affected.

How is it contracted and recognised?

Causes/infection

The precise cause is unknown. The disease is probably triggered by a reaction of the immune system against normal components of the liver cells, in a genetically predisposed individual. Sometimes a drug or alternative medicinal remedy may help to trigger the disease.

Symptoms

The symptoms are often vague: tiredness, abdominal pains, joint pains. It is not uncommon for there to be no symptoms and the disease is discovered by chance. In 20-30% of cases the disease manifests itself as acute hepatitis with jaundice (yellow colouring of the skin and eyes).

Diagnosis

The diagnosis is carried out by blood tests, which usually show increased liver values (transaminases), increased immunoglobulin G and the presence of antibodies.  A biopsy of the liver is essential to confirm the diagnosis.

How is it treated?

Terapie

Treatment is based on drugs that suppress the aggression of the immune system against the liver cells. Treatment is usually based on cortisone and azathioprine.  There are backup treatments in case of serious side effects or insufficient efficacy. A small number of patients do not respond sufficiently to the drugs and require a liver transplant.

Associated diseases

Other autoimmune diseases are often present, which involve most frequently the thyroid, skin, joints, major biliary ducts or intestine. Disease of the major biliary ducts and intestine is always looked for in children, adolescents and young adults and, especially in the case of an incomplete response to drug treatment, also in adults.