Autoimmune hepatitis is a condition in which the body's immune system attacks the liver, causing inflammation. Without treatment, the ongoing inflammation can lead to scarring and cirrhosis. With treatment, it can usually be controlled.
It can affect people of any age and is more common in women. It often occurs together with other autoimmune conditions, such as thyroid disease, type 1 diabetes or coeliac disease.
Symptoms
- Often none: many people are found to have it after a routine blood test shows abnormal liver results
- Tiredness, aching joints or discomfort under the right ribs
- Yellowing of the eyes or skin (jaundice) and dark urine
- Sometimes a sudden, severe hepatitis
Diagnosis
- Blood tests: liver enzymes, immunoglobulin G (IgG) and autoantibodies
- Ruling out other causes: such as viral hepatitis B and hepatitis C, fatty liver, alcohol, medicines and supplements, and rarer inherited conditions
- Liver biopsy: usually needed to confirm the diagnosis and see how much inflammation and scarring there is
- FibroScan and ultrasound: to check for scarring and follow it over time
Treatment
- Steroid medicine to bring the inflammation under control, which is then reduced gradually
- An immune-suppressing medicine, such as azathioprine, to keep it controlled over the long term
- Regular blood tests to check liver results and medicine side effects
- Bone protection, vaccinations and, if cirrhosis is present, six-monthly liver cancer checks
Most people need treatment for several years, and many need it long term. Stopping treatment is only considered after a long period of normal blood results, and with close monitoring, because the condition can come back.
Seek urgent care at an emergency department for yellowing of the eyes with confusion or drowsiness, vomiting blood, or black stools.
General information only. Reviewed by Dr Chia Chung King, 2026-11-07. Book a consultation.