- The Liver
- What is Liver Disease?
- Hepatitus B
- Hepatitus C
- Fatty Liver
- Autoimmune Hepatitus
- Cholestatic Liver Disease
- Liver disease treatment and Diagnostic Options
How do I get treatment?
For further information and appointments please see the below contact numbers:
For Mr Rob Hutchins:
020 7234 2940
For the following Consultants:
020 7234 2730
Professor Nigel Heaton
Professor Mohamed Rela
Mr Parthi Srinivasan
Mr Andreas A. Prachalias
Dr Phil M. Harrison
Dr Kosh Agarwal and
Dr Michael Heneghan
Autoimmune Hepatitis Treatment London
What is Autoimmune Hepatitis?
There are many causes of hepatitis and for example, alcohol excess and infections with various viruses are the common causes of hepatitis. Autoimmune hepatitis is an uncommon cause of persistent or long term (chronic) hepatitis which gradually damages the liver cells and often results in serious problems.
What causes autoimmune hepatitis?
The cause is not clear. It is thought to be an autoimmune disease. Although our immune system normally defends us against infection from viruses and bacteria, in people with autoimmune diseases, the immune system attacks particular parts of the body causing inflammation which may damage those affected areas.
In autoimmune hepatitis, it is the white blood cells known as lymphocytes which are mainly involved, attacking the liver cells which causes inflammation and damage.
Who gets autoimmune hepatitis?
It is a rare disease, with about 1 in 1,000,000 people in the UK developing the condition each year. About 7 in 10 cases are female, most commonly in those aged between 15 – 40. However, it does occur in young children and older adults who are mainly men that are affected.
People who have autoimmune hepatitis also have a high chance of having one or more other autoimmune diseases such as Pernicious Anaemia, Type I Diabetes, an overactive thyroid, Sjogren’s Syndrome or Vitiligo.
What are the symptoms of autoimmune hepatitis?
In many cases, symptoms develop gradually over weeks or months and include:
- Common early symptoms include fatigue, generally feeling unwell, mild pain in the upper abdomen over the liver, joint and muscle pains.
- Jaundice (turning yellow) develops when the liver inflammation becomes worse. Initially it will be noticed when the whites of the eyes become yellow. This is due to a build of bilirubin.
- Without treatment, in time the persistent inflammation cause liver damage called cirrhosis
In some cases, the symptoms develop very quickly over a few days with an “acute (sudden onset or short duration) hepatitis”. This can cause a fairly sudden onset of fever, abdominal pain, jaundice, feeling sick, vomiting and generally feeling unwell. In some cases, acute hepatitis settles down to become chronic hepatitis. In others, it can become so severe that it rapidly leads to liver failure .
The time it takes to develop severe cirrhosis varies from person to person. However if left untreated, most people diagnosed with autoimmune hepatitis can die within 10 years of the onset of the disease due to liver failure from cirrhosis. With treatment, the inflammation can usually be controlled, the outlook is positive and most people survive long term.
How is autoimmune hepatitis diagnosed?
Treatment of autoimmune hepatitis
Treatment aims to reduce inflammation and suppress the immune system with immunosuppressant drugs such as:
- Steroid (usually Prednisolone) medication is normally the first treatment, with a high dose needed initially. The dosage can then be reduced gradually over the weeks with the aim being to find the lowest dose possible to control the inflammation. This dose varies from patient to patient.
- Azothiaprine is an immunosuppressant drugs which works in a different way to steroids, and may be used in addition to steroids. However, it cannot be started until the inflammation has been brought under control with the steroid. Generally the two drugs work better than using just one alone, and it may well be that the steroid dose is less if you take Azothiaprine as well.
Usually the inflammation settles and symptoms improve within a few months of starting treatment. However, it may take a year or more to get the disease totally under control. Side-effects from the treatment may become troublesome in certain cases, but always the aim is to keep the medication dose as low as possible.
Once the condition has completely settled, it may be that your consultant will suggest a trial period without medication. However, in many cases, autoimmune hepatitis flares up again and it is necessary to re-introduce the medication. There are other drugs which can be used if steroids and/or azothiaprine do not work or if the side-effects become very severe.
For those people who do not respond to drug treatment, or who are diagnosed in the late stage of the disease with cirrhosis or liver failure, a liver transplant may be the option. The long term outlook after liver transplantation is very good.
Diet and Alcohol
Most people with autoimmune hepatitis will be able to eat a 'normal' healthy diet. However, anybody with inflammation of the liver are advised not to drink alcohol – or if they do, only in very small amounts. If you have been diagnosed with liver inflammation, alcohol may increase the risk and speed of developing cirrhosis.