Hepatitis, non-viral

Autoimmune hepatitis

Autoimmune hepatitis (AIH) is a chronic form of hepatitis, which mainly affects women. This is an autoimmune disease in which the body produces antibodies against its own liver cells. This way, the body attacks its own liver, damages the liver cells and causes hepatitis. The cause is unknown. Approximately 17 out of every 100,000 inhabitants suffer from autoimmune hepatitis. Of these cases, 70-80% are women, half of whom are under 30 years of age.
In a mild form, the condition can progress without any complaints. The first symptoms are usually quite vague, such as fatigue, loss of appetite (with aversion to fatty foods and alcohol), weight loss... In 30% of patients, the condition suddenly begins with jaundice. The skin and the white of the eyes turn yellow. Abdominal discomfort and joint pain can also occur.

Liver cirrhosis occurs at an advanced stage. In that case, the liver no longer works properly and blood flow is hampered by scarring.
Autoimmune hepatitis often occurs in combination with other autoimmune diseases such as Crohn's disease, celiac disease, type 1 diabetes and rheumatism.

The diagnosis is often an accidental finding following abnormal liver tests in a blood test. Special blood tests (anti-smooth muscle antibodies and LK membrane) can give a clue for the diagnosis, but often a definitive diagnosis is only possible with a liver biopsy.

In severe autoimmune hepatitis, treatment consists of medications that suppress immunity, such as cortisone and azathioprine. In case of liver cirrhosis and if the liver no longer works, a transplant may be necessary.

Alcoholic hepatitis

Prolonged alcohol consumption can also cause fatty liver, which can lead to alcoholic hepatitis. Hepatitis caused by alcohol consumption can also be acute, in which case the cause is a very large amount of alcohol. This is often accompanied by a prolonged period of unhealthy eating, an infection, vomiting or diarrhoea.

Non-alcoholic hepatitis (NASH)

Sometimes, fatty liver is caused by other reasons than alcohol consumption. This is called a non-alcoholic liver fat (NAFLD). Approximately 20-30% of people with NAFLD develop NASH: non-alcoholic liver infection/hepatitis. NASH gives rise to few or no symptoms. The cause is a disruption in the fat and/or sugar metabolism in the liver. Factors giving an increased risk of NAFLD and NASH are being overweight, obesity, insulin resistance, type 2 diabetes and metabolic syndrome.

Source: www.hepafocus.be

Latest publication date: 08/12/2023
Supervising author: Dr Monsaert Els