Autoimmune hepatitis is a disorder of unidentified etiology, causing acute and chronic liver disease. The prevalence rate of this disorder is 16.9 per 100,000 and annual occurrence of 1.9–3 per 100,000. It affects all ages and races, particularly black patients may have worse outcomes. It is characterized by a female preponderance and women are affected three times more commonly than men.
Can You Spread Autoimmune Hepatitis?
Autoimmune hepatitis is not contagious. It cannot spread from one person or organism to another, typically by direct contact. It is an autoimmune disease i.e. they occur when the immune cells in the body produce antibodies against its own cells and attack them. These antibodies are referred to as “auto-antibodies”. Autoimmune hepatitis in its initial stages does not produce any symptoms but can quickly progress to chronic hepatitis if not treated on time. Majority of the cases ultimately progress to liver failure through cirrhosis.
How Does It Occur?
Autoimmune hepatitis occurs in patients who have systemic autoimmune conditions like vasculitis, autoimmune thyroiditis, and celiac disease. More than half of the patients have chronic form of hepatitis that may resemble viral hepatitis but they do not show and confirmatory evidence of viral infection. Anti-smooth muscle autoantibodies also are believed to be associated with autoimmune hepatitis even though there is no concrete proof of such.
The disease condition is caused by T-cell rich interface hepatitis which has B cells and plasma cells which are associated with conditions like hypergammaglobulinemia and promote autoantibody production. There is strong evidence that autoimmune hepatitis is driven by antigen-specific T cells that expand as a consequence of a failure of immune tolerance, specifically in type 2 autoimmune hepatitis where both T cell and B-cell autoantigen have been defined as hepatic cytochromes.
Types of Autoimmune Hepatitis
Two types of autoimmune hepatitis are recognized according to seropositivity (results of a blood test). Smooth muscle antibody and/or antinuclear antibody define the type 1 and antibodies to liver-kidney microsome type 1 and/or liver cytosol type 1 defines type 2 autoimmune hepatitis. Type 1 affects both adults and children, while type 2 is mainly a pediatric disease, though it does occasionally affect young adults.
How Autoimmune Disease is Diagnosed?
The criteria for the diagnosis of autoimmune hepatitis have been established and revised by the International Autoimmune Hepatitis Group. The diagnosis of autoimmune disease is based on the presence of high level of aspartate aminotransferase, alanine aminotransferase, levels of IgG. A test is also conducted for checking positivity for circulating autoantibodies is also done for a definitive diagnosis. There have also been cases of cholestasis in some patients. In such cases, cholestatic forms of viral hepatitis, extra-hepatic obstruction, primary biliary cirrhosis, drug-induced disease, overlap syndromes, and primary sclerosing cholangitis must be taken into consideration.
Autoimmune hepatitis is not transmissible. It cannot spread from one person or organism to another, typically by direct contact. It is an autoimmune disease i.e. they occur when the immune cells in the body produce antibodies (called autoantibodies) against its own cells and attack them. It is generally present with no symptoms and can lead to chronic hepatitis if it is left untreated. Chronic hepatitis is the state of cirrhosis which may progress to liver failure. Autoimmune hepatitis also observed in patients who have systemic autoimmune conditions such as celiac disease, vasculitis, and autoimmune thyroiditis. The pathogenesis of autoimmune hepatitis is not entirely clear, although there is some proof in the literature about genetic vulnerability, molecular composition, and immune dysregulation which play a part in activating an autoimmune attack.
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