Autoimmune hepatitis

Autoimmune hepatitis (AIH) is a progressive necro-inflammatory liver disease associated with significant morbidity and mortality. It affects mainly females and has a varied clinical presentation from minor symptomatology to acute liver failure. The diagnosis should be considered in anyone with abnormal liver function tests. Diagnostic features include biochemical evidence of transaminitis, elevated immunoglobulin G and positive autoantibodies. Liver biopsy may show interface hepatitis with portal-based plasma cell infiltrates. AIH responds promptly to immunosuppression therapy including corticosteroids (prednis(ol)one or budesonide) with azathioprine. Joint care between primary healthcare and hepatology services is required to monitor treatment efficacy and adverse effects, in addition to seeking signs of cirrhosis and liver failure.