Autoimmune hepatitis: diagnosis, treatment, and prognosis

Autoimmune hepatitis (AIH) is an idiopathic hepatitis of unknown cause characterized by histologic evidence of chronic inflammation, liver autoantibodies, and increased gamma globulins in the serum. The clinical manifestations of AIH have been known since the 1950s and are essentially unchanged over the past 50 years. The cornerstone of therapy for AIH is immunosuppression using prednisone and azathioprine, with the vast majority of patients achieving clinical remission. This review provides a concise summary of the diagnostic criteria for AIH, describes its proposed pathogenic mechanisms and epidemiology, and offers an algorithmic approach to its initial treatment and follow-up.