Hepatitis - Autoimmune Hepatitis

Investigative Agents. In severe cases, drugs that block the immune system may be used:

Azathioprine (Imuran) is often prescribed along with steroids to help reduce severe side effects caused by using steroids alone. Azathioprine also suppresses the immune system and helps prevent relapse, but the drug will not induce remission by itself. In one promising study, patients who continued to use azathioprine after prednisolone was withdrawn had no relapses for at least a year. Unfortunately, long-term use of azathioprine may increase the risk for cancer, although studies indicate that this risk is very low.
Cyclosporine A (Neoral) is another immunosuppressant and may prove to be a safe and effective alternative to corticosteroids.

Some important research is targeting agents that inhibit RNA--the genetic molecules that serve as messengers for regulating cellular processes. In a 2003 animal study, an agent that targeted RNA specifically affecting cell receptors involved in liver injury protected against autoimmune hepatitis in mice.

Liver Transplantation and Autoimmune Hepatitis. If all therapies fail and the disease becomes life threatening, liver transplantation may be performed. Liver transplantation is problematic, however. In one study, half of patients who received a transplant required re-transplantation within a year. Autoimmune hepatitis recurred in 25% of patients studied. (According to one 2000 study, transplantation in these patients may improve accompanying autoimmune disorders in half of patients who experienced it.) Children who develop autoimmune hepatitis after liver transplantation may respond to corticosteroid and azathioprine therapy.