Hepatitis is inflammation of the liver, commonly caused by viruses that lead to hepatitis A, B, C, D, and E. However, some forms of hepatitis are not caused by viruses, including autoimmune hepatitis.
Unlike viral hepatitis, which is contagious and can be prevented through vaccination, autoimmune hepatitis is not contagious.
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What is Autoimmune Hepatitis?
Autoimmune hepatitis is a chronic liver inflammation caused by the immune system mistakenly attacking healthy liver cells. This immune response leads to liver inflammation, swelling, and damage.
Autoimmune hepatitis is classified as an autoimmune disease. There are two types:
- Type 1 Autoimmune Hepatitis: The most common form, affecting people of all ages.
- Type 2 Autoimmune Hepatitis: Less common and typically affects children and young adults.
The key difference between the two is the type of antibodies attacking the liver.
Symptoms of Autoimmune Hepatitis
The symptoms of autoimmune hepatitis vary among individuals. Some may experience mild or no symptoms at all, while others develop severe symptoms.
Common symptoms include:
- Fatigue
- Abdominal discomfort
- Yellowing of the eyes and skin (jaundice)
- Enlarged liver
- Spider angiomas (visible blood vessel expansion on the skin)
- Skin rashes
- Joint pain
- Missed menstrual cycles
- Dark urine
- Pale, clay-colored stools
- Loss of appetite
- Vomiting blood or rectal bleeding
- Confusion
- Swollen abdomen due to fluid buildup
Causes of Autoimmune Hepatitis
The exact cause of autoimmune hepatitis remains unknown. However, it occurs when the immune system mistakenly targets healthy liver cells instead of harmful pathogens like viruses, bacteria, and fungi.
This condition is often linked to hypergammaglobulinemia, where the body produces an excessive number of antibodies. Doctors also suspect that infections or certain medications may trigger autoimmune hepatitis in some individuals.
Risk Factors for Autoimmune Hepatitis
Several factors can increase the risk of developing autoimmune hepatitis, including:
- Being female
- Genetic predisposition (family history)
- Having other autoimmune diseases such as rheumatoid arthritis, celiac disease, hyperthyroidism (Graves’ or Hashimoto’s disease), or type 1 diabetes
- Hepatitis virus infection
- Epstein-Barr virus (mononucleosis)
Since autoimmune hepatitis is not caused by a virus, it is not contagious.
Diagnosis of Autoimmune Hepatitis
Doctors diagnose autoimmune hepatitis through physical examinations and laboratory tests, including:
- Liver function tests
- Complete blood count (CBC)
- Coagulation panel
- Electrolyte panel
- Autoimmune antibody tests
- Liver enzyme tests (SGOT, SGPT)
Additionally, imaging tests may be conducted to assess liver inflammation, swelling, or enlargement:
- CT scan
- MRI
- Liver ultrasound
- Liver biopsy
Treatment for Autoimmune Hepatitis
While autoimmune hepatitis may not be completely curable, it can be managed effectively. Many individuals live symptom-free for years, a condition known as remission.
The primary goal of treatment is to slow or halt disease progression, preventing further liver damage. Treatment typically involves medications that suppress the immune system, such as:
- Corticosteroids (e.g., prednisone)
- Immunosuppressants (e.g., azathioprine)
These medications must be taken long-term, often for six months to several years, to achieve remission. Some patients may continue medication indefinitely, while others may eventually stop treatment, though relapses can occur.
In cases where medication is ineffective, liver transplantation may be necessary.
Complications of Autoimmune Hepatitis
Untreated or late-diagnosed autoimmune hepatitis can lead to severe complications, including:
- Enlarged veins in the esophagus (esophageal varices)
- Fluid buildup in the abdomen (ascites)
- Liver failure
- Liver cancer
The earlier autoimmune hepatitis is diagnosed and treated, the better the chances of recovery. If you experience persistent discomfort in the upper abdomen along with other symptoms, consult a hepatologist or internal medicine specialist, especially if you have risk factors.
Regular health check-ups are advisable, as autoimmune hepatitis can develop silently without noticeable symptoms.
For expert consultation, visit Mandaya Liver Center at Mandaya Royal Hospital Group. Book an appointment via WhatsApp chat, online booking, or download the Care Dokter app from Google Play or the App Store for easy scheduling.
