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How is autoimmune hepatitis treated?

Early treatment of autoimmune hepatitis is vital to control disease progression, prevent, and even reverse some liver damage. Treating this condition involves suppressing the patient's overactive immune system. This is accomplished by treating (both types of) autoimmune hepatitis with the lowest dose of prednisone that is effective. A corticosteroid, prednisone, dampens the immune response and reduces chronic liver inflammation. A recent European study suggested that budesonide, a steroid with less systemic toxicity, may be equally effective. Physicians will also usually prescribe azathioprine, or Imuran, another immunosuppressant drug which works differently than prednisone and which enables lower doses of prednisone to be given.

All patients with autoimmune hepatitis are followed closely to monitor liver function. Treatment with prednisone is usually long-term, and may sometimes be discontinued; in this case, patients should be aware that symptoms may return, and that keeping in close touch with their physician is very important. Over seventy-percent of patients with this disease will experience a remission within two years of beginning treatment. Of these, some will have a relapse, requiring repeat or even indefinite treatment with immunosuppressant drugs. In such patients, the physician attempts to use the lowest dose of immune suppressive medications needed to control the disease.

Side-effects of prednisone include weight gain, anxiety, osteoporosis, diabetes, high blood pressure, cataracts and glaucoma. Side-effects of azathioprine include low white blood cell count, nausea and no appetite. Rarer are pancreatitis (inflammation of the pancreas and stomach pain), liver damage and allergic reaction.

Other immunosuppressant drugs which can be used include mycophenylate mofetil, cyclosporine or tacrolimus.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.