Autoimmune hepatitis: current concepts in epidemiology, diagnosis, and management
- Author:
Brian J. WENTWORTH
1
;
Kwang Il SEO
Author Information
- Publication Type:Review article
- From:Kosin Medical Journal 2025;40(4):249-269
- CountryRepublic of Korea
- Language:English
- Abstract: Autoimmune hepatitis is a rare immune-mediated liver disease that can progress to cirrhosis and liver failure. Its global incidence and prevalence are increasing, with a marked female predominance and substantial regional variation. Diagnosis requires the exclusion of alternative causes of liver disease and the integration of clinical, serologic, and histologic features. First-line induction therapy has traditionally relied on corticosteroids, with or without azathioprine, although recent evidence supports mycophenolate mofetil as an alternative first-line, steroid-sparing agent. Nonetheless, a subset of patients are intolerant of or have an inadequate response to first-line therapies, which complicates management and necessitates the use of less well-validated immunosuppressive regimens. Special clinical situations, including pregnancy, overlap syndromes, liver transplantation, and hepatocellular carcinoma, pose additional management challenges. For most patients, the primary therapeutic goal is complete biochemical response, although subclinical histologic inflammation may persist in some cases. Accordingly, careful long-term monitoring is essential to assess disease progression and to detect disease-specific or immunosuppression-related complications. This review concisely summarizes the current literature on autoimmune hepatitis and provides busy clinicians with a practical, evidence-based primer on disease management.
