Autoimmune Hepatitis Management: Recent Advances and Future Prospects

Author:

Sierra Rebeca1,Marenco-Flores Ana2,Alsaqa Marwan2ORCID,Barba Romelia3,Cuellar-Lobo Marcela4ORCID,Barberan Carla5ORCID,Sierra Leandro2ORCID

Affiliation:

1. Department of Medicine, Universidad de la Sabana, Bogotá 250001, Colombia

2. Division of Gastroenterology, Hepatology, and Nutrition, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA

3. Department of Medicine, Texas Tech University, Lubbock, TX 79409, USA

4. Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA

5. Department of Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA

Abstract

Autoimmune hepatitis (AIH) is a varied inflammatory chronic liver disease. AIH’s prevalence varies and has increased recently. Diagnosis involves the discovery of histologic features following liver biopsy and serologic testing. Clinical features vary, and up to 40% of patients may be asymptomatic. Evaluating thiopurine methyltransferase (TMPM) activity before treatment is crucial for an optimal response. The primary treatment goal is biochemical remission, normalized serum IgG, and liver enzymes. Induction therapy typically involves azathioprine and corticosteroids. Close monitoring of liver function tests and serum immunoglobulin levels is essential. Medications can be tapered after achieving biochemical remission. Liver transplantation may be required for refractory disease or cirrhosis. Further therapeutic approaches are needed, particularly for non-responders to first-line treatments.

Publisher

MDPI AG

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