June 26, 2005

It is not uncommon for patients with autoimmune hepatitis (AIH), a disease in which the patient's own immune system attacks the liver, to have no symptoms.

Such cases are being diagnosed more frequently due to the increased practice of administering routine liver enzyme and antibody tests. Whether or not to treat asymptomatic AIH remains unclear, as therapy with immunosuppressants could potentially slow progress of the disease but involves side effects that are sometimes toxic.

In order to determine whether immunosuppressive therapy is indicated when no symptoms are present, researchers led by Jordan Feld of the Departments of Medicine and Pathology at the University Health Network of the University of Toronto, compared the natural course of asymptomatic AIH with symptomatic AIH.

The results of the study indicated that asymptomatic patients had lower liver enzyme and IgG antibody levels, as well as lower scores on the hepatic activity index, which measures liver inflammation, but otherwise did not differ from patients with symptoms. Half of the asymptomatic patients ended up receiving treatment either because it was already started by their physicians or because they eventually developed symptoms.

The results of the study appear in the July 2005 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases.