Livers, Vol. 4, Pages 240-252: Autoimmune Hepatitis Management: Recent Advances and Future Prospects
Livers doi: 10.3390/livers4020017
Authors: Rebeca Sierra Ana Marenco-Flores Marwan Alsaqa Romelia Barba Marcela Cuellar-Lobo Carla Barberan Leandro Sierra
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.