Autoimmune hepatitis
Content date: 10 November 2026
Treatment calms the immune attack on the liver. Normal blood tests are a good sign, but do not mean it is safe to stop treatment without supervision.
Your next step
Confirm your dose plan and treatment-safety blood test appointment before medicine runs out.
Get urgent help: Severe jaundice with confusion, gastrointestinal bleeding, breathing difficulty or rapid general deterioration.
Why does the immune system attack the liver?
- The immune system protects the body from infection. In this condition it mistakenly recognizes some liver cells as foreign, causing ongoing inflammation. The precise cause is unknown, and genetic susceptibility and other factors may interact. It is not caused by poor hygiene or an infection that can spread to your family.
- It can affect women and men at different ages and may coexist with other autoimmune conditions, such as some thyroid diseases. Another autoimmune condition does not automatically establish autoimmune hepatitis; the liver needs its own assessment.
Understanding active disease and remission
- It may be discovered through elevated blood tests without symptoms, or cause tiredness, joint pain, nausea or jaundice; occasionally it starts severely. Persistent inflammation may lead to scarring and fibrosis, so few symptoms do not always reflect little activity inside the liver.
- Medicine aims to stop the immune attack, bring tests to target levels and protect liver tissue. Control of disease activity is called remission, which does not necessarily remove susceptibility to the disease. Your doctor therefore balances the lowest effective dose against treatment effects and monitors tests even when you feel better. Disease can reactivate after stopping treatment; this does not mean previous treatment was pointless.
How is it diagnosed?
- We combine blood tests, antibodies and immune proteins in the blood while ruling out other causes. A biopsy may be needed to confirm the diagnosis and assess inflammation.
- One positive test alone is not enough to confirm the condition.
How is it treated?
- Treatment often begins with corticosteroids and another immune-suppressing medicine, such as azathioprine or mycophenolate mofetil, according to your situation. Mycophenolate is unsuitable for pregnancy and requires contraception planning and a supervised switch before pregnancy.
- Doses are reduced gradually according to response and side effects. Do not stop steroids suddenly or change the dose yourself.
- Treatment may continue for years or lifelong. A trial of withdrawal suits only a small selected group after sustained remission and specialist assessment, with close follow-up.
Safe medicine monitoring
- Keep appointments for liver tests, blood counts and other tests required for your medicine. Special tests may be needed before some treatments.
- Report fever, severe sore throat, mouth ulcers, unusual bruising or severe abdominal pain.
- Discuss vaccinations, sun protection and preventive screening appropriate to your age and treatment. Do not receive a live vaccine without your team’s approval.
Bones, pregnancy and lifestyle
- Steroids can affect blood glucose, blood pressure, bones and mood. Depending on assessment, you may need vitamin D, calcium or bone-density testing.
- Eat a balanced diet, remain active within your ability, and avoid alcohol and unknown supplements. No special diet replaces treatment.
- If planning pregnancy, discuss it early with your doctor; some medicines are unsuitable and need to be changed beforehand. Do not stop medicines yourself if you become pregnant.
When to get help
Severe jaundice with confusion, gastrointestinal bleeding, breathing difficulty or rapid general deterioration.
Fever during immunosuppression, new jaundice, bruising or mouth ulcers, or difficulty obtaining treatment; contact the team the same day for fever.
Guides for your care journey
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