Autoimmune Hepatitis: Updates on Epidemiology, Pathogenesis, Risk Factors, Diagnostics and Pharmacological Management

Autoimmune hepatitis (AIH) is a rare, chronic liver disease characterized by inflammation and immune-mediated damage to the liver tissue. The disease can have an acute or chronic progressive course and may eventually result in progressive liver fibrosis, cirrhosis, and/or liver decompensation, with some patients requiring a liver transplantation (LT). Risk factors such as certain ethnic backgrounds, the presence of comorbidities, lifestyle and dietary aspects, and adequacy of the treatment response can affect disease progression and the likelihood of the development of adverse clinical events. Several blood-based biomarkers and scores can help distinguish advanced fibrosis or cirrhosis, but their utility in differentiating earlier histological stages of fibrosis is less clear. There is a current shift away from liver biopsy and toward noninvasive radiological techniques, such as vibration-controlled transient elastography, shear wave elastography, acoustic radiation force impulse imaging, and magnetic resonance elastography, which opens promising avenues for their wide practical application. The standard treatment of AIH involves the use of corticosteroids and immunomodulators, with the consideration of novel therapies for non-responders.