Autoimmune Hepatitis

Autoimmune Hepatitis

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Autoimmune hepatitis is a chronic disease in which your immune system attacks your liver. While the condition can be controlled with medication, autoimmune hepatitis that has progressed or is diagnosed at later stages can lead to liver failure. Severe autoimmune hepatitis may require advanced treatments, including a liver transplant. The hepatologists at Duke are experts in treating autoimmune hepatitis. We help you manage your condition, monitor its progression, and help you prepare for a liver transplant if it becomes necessary.

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About Autoimmune Hepatitis

More Common in Women
While the cause of autoimmune hepatitis is unclear, the condition is known to occur more often in women and to run in families. It is more commonly found in people with other autoimmune conditions, such as rheumatoid arthritis, thyroid disease or inflammatory bowel disease.

Seek Care if You Have Autoimmune Hepatitis Symptoms
Symptoms may not appear in the early stages of autoimmune hepatitis. As the condition progresses, joint pain, skin rashes, nausea, poor appetite, and fatigue may occur. If you have these symptoms, it’s important to seek medical care with a hepatologist as soon as possible. Liver specialists at Duke will diagnose your condition and start treatment promptly. This will minimize your symptoms and keep your liver as healthy as possible. Most people with autoimmune hepatitis do well and never need a liver transplant.

Why Early Diagnosis and Expert Treatment is Important
Left untreated, inflammation caused by autoimmune hepatitis can result in permanent scarring of your liver, called cirrhosis. Liver cancer, liver failure, and other serious complications may also occur. 

Treatment for Complications
If autoimmune hepatitis leads to cirrhosis and other health problems, our hepatologist will work with other specialists to recommend the most effective treatment for your condition.

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Duke Health offers locations throughout the Triangle. Find one near you.


If autoimmune hepatitis is suspected, your hepatologist will conduct an extensive medical history and physical exam. One or more of the following tests may be prescribed to confirm your diagnosis or to evaluate whether your condition has progressed.

Blood Tests

Lab work can measure levels of specific liver enzymes that may indicate whether you have autoimmune hepatitis, viral hepatitis, an inherited liver disorder, or potentially NASH (nonalcoholic steatohepatitis, a disease in which people who drink little or no alcohol develop fat, inflammation, and scarring in their livers).

Ultrasound, CT, MRI

These imaging tests can help diagnose complications that can result from autoimmune hepatitis.


A small piece of liver tissue is removed using a thin needle inserted through the abdomen. A biopsy can show the extent of liver scarring and help confirm the diagnosis of autoimmune hepatitis, as well as guide treatment decisions.

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Autoimmune hepatitis can range from mild to severe. Your Duke hepatologist will consider all aspects of your condition and recommend one of these treatments:


Corticosteroids (prednisone or prednisolone) can slow and often stop your immune system’s attack on your liver. These drugs are frequently used in combination with other immunosuppressants such as azathioprine, mycophenolate, tacrolimus, or cyclosporine in order to minimize side effects and maximize effectiveness.  An effective drug regimen can relieve symptoms and commonly leads to a remission, in which symptoms disappear and tests of liver inflammation normalize. Liver damage may be reversed. This treatment requires ongoing management by a hepatologist, who will monitor your medication levels and ensure you don’t have a relapse after your condition improves. Your hepatologist will also work to  minimize the doses of medication needed to keep your liver healthy.

Liver Transplantation

Most people with autoimmune hepatitis do well with medication. However, if you have liver failure, liver cancer, or another severe condition that results from autoimmune hepatitis, you may be evaluated for a liver transplant. A transplant involves removing your diseased liver and replacing it with a healthy organ. If you are recommended for transplant, you will work with our experienced transplant team and receive comprehensive, personalized care -- before, during, and after your surgery.

Among the Best Hospitals for GI in the U.S.
Where you receive your care matters. Duke University Hospital is ranked among the best in the nation for gastroenterology and GI surgery by U.S. News & World Report for 2019–2020.

Why Choose Duke

Extensive Experience, Individualized Treatment
Our liver specialists have extensive experience treating people with autoimmune hepatitis and other liver conditions. We offer the most advanced treatments and individualize your treatment to ensure you experience the best possible outcome.

A Team of Liver Specialists
Your team will include a range of specialists who work together to give you the highest level of care. Our hepatologists, surgeons, nutritionists, social workers, transplant coordinators, and others design a care plan that considers not just your physical condition but also your emotional and psychological well-being.

Families Welcome
We understand the important role family and friends play in helping you through this journey. With your approval, we include your family as part of your care team and keep them up to date on your condition and treatments.

If You Need a Liver Transplant
Our liver transplant program will do our best to ensure you live a long, productive life after your liver transplant. National data show that Duke’s adult liver transplant outcomes are among the nation’s best.

Success with the Most Challenging Patients
We have the experience and resources to offer hope to people who need a liver transplant who have been turned down by other centers. We work closely with cardiologists, infectious disease doctors, and pulmonologists who specialize in evaluating patients for liver transplantation. Our success comes from the dedication of each team member to providing personalized care for each patient.

Reviewed: 09/06/2018