The treatment of autoimmune hepatitis involves the use of corticosteroids with or without immunosuppressive drugs and begins after the diagnosis made by the doctor by analyzing the signs and symptoms that the person presents and the results of laboratory tests. necessary, such as measurement of liver enzymes, immunoglobulins and antibodies, and liver biopsy tests.
When the person does not respond to drug treatment or when the disease is already at a more advanced level, the hepatologist or family doctor may recommend a liver transplant. In addition, to complement medical treatment, it is recommended that patients eat a balanced diet low in alcoholic beverages and fatty foods, such as cold cuts or snacks.
Learn more about autoimmune hepatitis
The treatment of autoimmune hepatitis can be done with corticosteroids, immunosuppressants or, in more severe cases, with liver transplantation. In general, drug treatment for autoimmune hepatitis must be continued for life to keep the disease under control.
Corticosteroids, such as prednisone, are used to reduce inflammation of the liver caused by the action of the immune system on liver cells. Initially, the corticosteroid dose is high, but as treatment progresses, your doctor may reduce the amount of prednisone to the minimum needed to keep the disease under control.
However, the use of corticosteroids has side effects such as weight gain, weakening of the bones, diabetes, increased blood pressure or anxiety and, therefore, it may be necessary to make an association with immunosuppressants to reduce side effects, in addition of necessity. for periodic follow-up by the doctor.
Corticosteroid use is indicated in people with more disabling symptoms, such as fatigue and joint pain, for example, when the person has highly modified levels of liver enzymes or gammaglobulins, or when necrosis of liver tissue is checked during biopsy.
Corticosteroids, such as azathioprine, are indicated to decrease the activity of the immune system and thus prevent the destruction of liver cells and chronic inflammation of the organ. Azathioprine is generally used in combination with corticosteroids to reduce the side effects associated with this treatment.
During treatment with immunosuppressive drugs, such as azathioprine, the patient should undergo regular blood tests to evaluate the number of white blood cells, which may decrease and facilitate the onset of infections.
Liver transplantation is used in the most severe cases of autoimmune hepatitis, when the patient develops cirrhosis or liver failure, for example, and is used to replace the diseased liver with a healthy liver. Learn more about liver transplantation.
After liver transplantation, the patient should be hospitalized for 1 to 2 weeks to make sure there is no rejection of the new organ. In addition, transplanted people should also take immunosuppressants throughout their lives to prevent the body from rejecting the new liver.
Although this is an effective form of treatment, the disease may occur again because autoimmune hepatitis is related to a person’s immune system, not the liver.
Signs of improvement in autoimmune hepatitis usually appear a few weeks after starting treatment and are related to a decrease in symptoms, allowing the patient to lead a normal life.
When treatment is not done correctly, the patient can develop cirrhosis, encephalopathy, or liver failure, showing signs of worsening that include generalized swelling, changes in smell, and neurological problems, such as confusion. and drowsiness.