This complication is much less common in the Western World. The disease becomes life-threatening only after cirrhosis has developed. More than half of all patients live at least 15 years from the time of the first diagnosis and this number is continuously improving. Previously, prognosis was thought to depend on what was found on liver biopsy. This is now only partly true.
Prognosis is worse and complications more numerous and severe if cirrhosis has already developed.
Much attention has been paid to the location and extent of the inflammation of the liver. Steroid therapy remains the only useful treatment for autoimmune disease, but it may have to be given for a lifetime and may also not prevent the ultimate development of cirrhosis. Liver transplantation has become an accepted form of therapy when chronic hepatitis becomes life-threatening, usually as a result of complications of cirrhosis. Recurrence of hepatitis C or autoimmune hepatitis does not seem to occur, but hepatitis B, if virus is still present and the patient is contagious, will recur in the new liver and often be acute. Attempts are being made to prevent this recurrence.