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Autoimmune Hepatitis
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Treatment of Autoimmune Hepatitis

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The standard treatment is a combination of: 

Blue, white and green pills

Corticosteroids (prednisone and budesonide) to control liver inflammation. 

Side effects of corticosteroids

The main side effects of prednisone include weight gain, acne, loss of bone mass, elevated blood glucose levels (which can lead to diabetes), increased risk of infections, cataracts, high blood pressure and mood or sleep disturbances, among others. People who need long-term prednisone treatment are monitored regularly to detect these side effects. To minimise risks, the lowest effective dose of prednisone is used. 
 
Budesonide, on the other hand, is a corticosteroid that acts more specifically on the liver and is associated with fewer side effects. It is an alternative to prednisone in selected cases, but should be used only in patients with no evidence of cirrhosis.

Pills and tablets

Immunosuppressants, such as azathioprine and mycophenolate mofetil, are also used to help reduce the corticosteroid dose and minimise side effects. 

Both azathioprine and mycophenolate can also cause side effects, such as a low white blood cell count. However, these effects are infrequent and are checked for by healthcare professionals. There may also be a slight increase in the risk of certain cancers, such as lymphoma and skin cancer, although the overall risk is very low. 

In 30–40% of patients, the standard treatment may not be sufficient. In these cases, other medications such as tacrolimus or rituximab may be used. 

The goal of treatment is to normalise liver biochemistry and prevent disease progression. According to current guidelines, treatment should be continued for at least two years after blood test results return to normal. After that, the dose and duration of therapy are decided according to each patient’s individual characteristics. 

Liver

In severe cases, such as fulminant hepatitis or decompensated cirrhosis, a liver transplant may be required. 

Read more Living with the disease
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Substantiated information by:

María Carlota Londoño Hurtado
Pinelopi Arvaniti

Published: 27 October 2025
Updated: 30 October 2025

The donations that can be done through this webpage are exclusively for the benefit of Hospital Clínic of Barcelona through Fundació Clínic per a la Recerca Biomèdica and not for BBVA Foundation, entity that collaborates with the project of PortalClínic.

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