title: Autoimmune hepatitis: an approach to disease understanding and management.
abstract: BACKGROUND
  Autoimmune hepatitis is a chronic immune-mediated liver injury, frequently associated with progression to end-stage liver disease if untreated. Patients commonly present with hepatitis, positive immune serology, elevated immunoglobulins and compatible liver histology, in the absence of an alternative aetiology.
  
  
  METHODS
  Data for this review were obtained using PubMed.
  
  
  RESULTS
  Disease usually responds to steroids and azathioprine, and appears to be a manifestation of autoimmune predisposition triggered in genetically susceptible individuals exposed to likely environmental challenges. We provide an up-to-date approach to disease understanding and management along with the clinical approach to diagnosis and current treatment suggestions.
  
  
  RESULTS
  Controversies such as second line therapies and novel markers of disease activity are introduced.
  
  
  CONCLUSIONS
  Increased understanding of the immunoregulatory mechanisms behind autoimmune hepatitis has led to opportunities for new therapies. These are developed including a discussion of timely research studies relevant to future therapies for patients.
authors.affiliation: NIHR Biomedical Research Unit and Centre for Liver Research, University of Birmingham, Birmingham, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Corrigan
authors.affiliation: NIHR Biomedical Research Unit and Centre for Liver Research, University of Birmingham, Birmingham, UK g.hirschfield@bham.ac.uk.
authors.forename: Gideon M
authors.initials: GM
authors.lastname: Hirschfield
authors.affiliation: NIHR Biomedical Research Unit and Centre for Liver Research, University of Birmingham, Birmingham, UK.
authors.forename: Ye H
authors.initials: YH
authors.lastname: Oo
authors.affiliation: NIHR Biomedical Research Unit and Centre for Liver Research, University of Birmingham, Birmingham, UK.
authors.forename: David H
authors.initials: DH
authors.lastname: Adams
mesh_terms: D001379:Azathioprine / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation; D018579:Patient Selection; D012008:Recurrence; D012074:Remission Induction
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D001379:Azathioprine
keywords: autoimmune liver disease; azathioprine; immune mediated liver disease; prednisolone