Autoimmune hepatitis has a tendency to have different characteristics in persons who come down with this disease. In those who have mild disease, there is a small chance that it will develop into cirrhosis. People with mild disease usually have spontaneous remissions. In those people who have developed cirrhosis because of autoimmune hepatitis, another complication for them may be liver cancer. Steroids are the primary treatment and many clinical studies have shown that steroid therapy leads to major improvements in clinical symptoms and blood tests as well as increased survival.
Prednisone seems to be the most widely used of the steroids by most physicians.
The other treatment is a combination of prednisone and azathioprine in which the major advantage is that the dose of steroids is reduced which minimizes the complications that result from prolonged steroid use. However, azathioprine itself may produce significant side effects, especially suppression of the immune system, that may or may not be an improvement over the effects of prolonged steroid use. By itself, azathioprine, by itself, is not effective in achieving a remission. The current therapy is suggested and effective in severe forms of autoimmune hepatitis but not recommended for mild forms or those that are asymptomatic. Therapy should continue for at least 12-18 months.