Living with Autoimmune Hepatitis

Different from many types of hepatitis resulting from viruses, autoimmune hepatitis (AIH) is a rare disease in which the body's immune system attacks our own liver cells. Chronically, AIH leads to cirrhosis (scarring) of the liver and may ultimately turn into liver failure. Though it's reported that about 100,000-200,000 people are living with the AIH condition in the U.S, researchers haven't completely figured out the causes for autoimmune hepatitis.

Signs & Symptoms

AIH can be divided into two types based on serum tests, both of which predominantly affect women. Type I is the main form of autoimmune hepatitis that young women in the United States are suffering from, while Type II primarily affects girls between the ages of 2 and 14.

The symptoms of both types vary from individuals, generally including fatigue, itching, aching joints, and abdominal pain. But some patients would have mild or no signs in the early stage, then suddenly or gradually develop uncomfortable feelings in later stages.

Indirect signs include yellowing of the skin and eyes (jaundice), itching caused by a build-up of bile, fatigue, loss of appetite, nausea, vomiting, joint pain, and abdominal discomfort. The affected people will be observed with symptoms like enlarged liver (hepatomegaly), abnormal blood vessels on the skin (spider angiomas), abdominal distention (swelling), dark urine, and pale-colored stools.

Diagnosis

Overall, the blood test is required as it advances the diagnosis of AIH from three aspects:

1. Exclude viral hepatitis as its symptoms are very similar to those of AIH.
2. Identify the type of AIH
3. Check and determine the current condition and function of the liver

Moreover, the blood test is also a means of detecting the levels of specific autoimmune hepatitis antibodies, such as anti-smooth muscle antibody, anti-liver kidney microsome type I antibody, and anti-nuclear antibody.

To specify the type and severity of the liver damage and inflammation, sometimes it's necessary to perform a liver biopsy, which involves removing and sending a small piece of a sample of liver tissue to a laboratory for testing. Several biomarkers for liver diseases have been identified, driving the development of IVD immunoassays for disease severity, progression, and regression assessment.

Treatment

Actually, not all people diagnosed with AIH require immediate treatment. Instead, it should be based on the result of the blood test and disease progression. Usually, hepatologists will propose treatment to slow down, stop, and sometimes reverse liver damage, but most of the time, people living with autoimmune hepatitis will stay in remission for 2-3 years.

Some common medications will be used in the process of treating AIH. For instance, immunosuppressant drugs are able to stop the immune system’s attack, while they possibly will compromise the body’s ability to fight other infections. Other treatments are also induced to ease the condition, such as corticosteroids and liver transplantation.

Patients should be aware of the possible side effects of any treatment, including allergic reactions, inflammation of the pancreas, abnormal liver blood tests, and an increased risk of developing certain cancers. And the most important part of AIH treatment is to visit the hepatologist and continuously monitor the condition.

What others to notice?

Patients with AIH sometimes may feel isolating. Therefore, it's critical to find support and comfort from other aspects. AIH patients are likely to be depressed by the question "How long I can live with autoimmune hepatitis?".

Indeed, 50% of patients with severe autoimmune hepatitis will die in approximately 5-10 years, only if he or she doesn't accept any treatment. Fortunately, treatment with corticosteroids has been shown great potential to improve the chances of survival. And proper dietary changes can help reduce possible side effects. For example, maintaining a diet with enough calcium can lower the risk of osteoporosis and bone fracture resulted from prednisone. In addition, connecting with others who are also living with AIH can be extremely helpful in mental.

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