Autoimmune Hepatitis: When Your Immune System Attacks the Liver

December 22, 2025

Autoimmune Hepatitis: When Your Immune System Attacks the Liver

Verified By
KIMS-SUNSHINE
Specialist,
22 December, 2025

Autoimmune Hepatitis: When Your Immune System Attacks the Liver

We know that hepatitis is caused when the liver gets inflamed and damaged. The inflammation can be due to a variety of reasons. Autoimmune hepatitis is a form of liver disease where the immune system works overtime and begins to destroy healthy liver tissue. When this continues for a long time undetected, it can severely impact liver function and cause a few signs and symptoms that are subtle at first and easy to dismiss. These symptoms may get more severe and finally, you may have to deal with liver failure. Studies show that there may be up to a 11% incidence of autoimmune hepatitis in all chronic liver disease patients. More women get affected when compared to men and it is associated with other autoimmune disorders that affect the gut or the thyroid gland.

Liver disease symptoms

Some of the most common symptoms at the beginning are subtle and so easily ignored. There are 2 types

Type 1- More prominent in women who have anti- SMA antibodies.
Type 2 is rarer but is present from childhood when the affected individual has anti-liver-kidney microsomal-1 antibodies.

Most people associate liver disease with jaundice, itchy skin, rashes, severe nausea, vomiting and abdominal pain respectively. Other signs include dark-coloured urine and pale or grey coloured faeces. Fatigue is a prominent syndrome with liver disease.

Diagnosis of Autoimmune Hepatitis

Chronic liver inflammation can cause elevated liver enzymes- which is how it is mostly confirmed using simple blood tests. Autoimmune hepatitis is caused when you have mutated genes, or are infected with viruses like hepatitis A, B or C, among others. Some other tests used include-

Liver function tests to check for elevated levels of liver enzymes, as mentioned above.
Antibody tests- to check for SMA or related antibodies from blood.
Imaging like MRI or CT scans can help in visualising the extent of inflammation and tissue damage.
A liver biopsy is a gold standard test used to confirm liver disease.

Treatment for Autoimmune Hepatitis

Steroid treatment for autoimmune hepatitis is a common first line of defense- you first begin with a high dose of corticosteroids to help calm your immune system down. Then, dosage is gradually reduced till you taper off it completely. Prednisone is normally used in such cases, but it has some unwanted side effects.

Immunosuppressant therapy is prescribed with steroids, but can be used for longer. It is useful as maintenance therapy and will help you manage your symptoms in the long term.

All medications prescribed try to get you into remission- where you are symptom free and your liver is not being attacked by your immune cells. Some people can go off immunosuppressants after a couple years, while many report relapses, in which case they will have to continue with medications. A liver transplant is offered in severe cases, where drugs don’t work anymore and the damage to the liver is too profound – and quality of life has plummeted significantly because of that. But, getting donor liver tissue is hard and so people may spend years on the transplant list.

Conclusion

Most individuals do well with medications alone though transplants may be necessary after many years, when drugs have stopped working as well as before. Early diagnosis is key to improving your chances of reaching remission- as damage to the liver is not as extensive. There is no permanent cure for this chronic condition but you may be in remission for a long time with the right combination of medications and lifestyle routines in place. Talk to an experienced hepatologist for more information and learn to manage your symptoms effectively in the long run.

Frequently Asked Questions

What is autoimmune hepatitis?

Autoimmune hepatitis is a long-term condition in which the immune system attacks liver cells, causing inflammation. Over time, this inflammation can damage the liver and affect how well it works. The cause is not fully understood, but it involves a loss of normal immune control rather than infection or alcohol use.

What are early symptoms of autoimmune hepatitis?

Early symptoms can be mild or absent. When present, they may include fatigue, abdominal discomfort, nausea, loss of appetite, joint pain, itching, and yellowing of the skin or eyes (jaundice). Some people are diagnosed after abnormal liver blood tests rather than symptoms.

Is autoimmune hepatitis a lifelong disease?

Autoimmune hepatitis is usually a lifelong condition. Many people need long-term treatment to keep the disease under control. Some may achieve remission, where symptoms and inflammation improve, but ongoing monitoring is required as the disease can become active again.

Can autoimmune hepatitis lead to cirrhosis?

Yes, untreated or poorly controlled autoimmune hepatitis can lead to cirrhosis. Cirrhosis is scarring of the liver that can impair liver function and cause complications. Early diagnosis and proper treatment reduce the risk of developing cirrhosis.

Can diet help manage autoimmune hepatitis?

Diet cannot cure autoimmune hepatitis, but it supports overall liver health. A balanced diet with adequate protein, fruits, vegetables, and whole grains is advised. Alcohol should be avoided, and maintaining a healthy weight helps reduce strain on the liver. Any supplements should be discussed with a healthcare professional.