AUTOIMMUNE HEPATITIS (AIH) is one of causes of chronic liver diseases. It is an unresolving inflammation of liver tissue and characterized by elevated transaminases, hypergammaglobulinemia, and circulating autoantibodies. The disorder occurs mostly in females (F:M ratio is 3.6 to 1) and is a relatively uncommon disorder with point prevalence of 8-16.8 per 100 000 population in western countries. Hiostologic hallmarks are interface HEPATITIS (also called piecemeal necrosis), and portallymphoplasmacytic infiltration.Dignostic criteria are based on excluding other etiologies of chronic liver disease,such as viral hepatic (A, B, C), metabolic disorders eg Wilson disese,drug induced HEPATITIS and alcoholic liver disease. Conventional autoantibodies are Antinuclear antibody (ANA), Smooth muscle antibody (SMA) and Anti liver kidney microsomal 1 (Anti LKM1).Some cases have combined clinical, laboratory or histologic features of Primary Biliary Cirrhosis (PBC) or Primary Sclerosing Cholangitis (PSC) with AIH and are known as overlap syndrome. Standard treatments of AIH as the most successful treated form of chronic HEPATITIS are based on immunosuppression with corticosteroids alone or in combination with azathioprine.

Background: Advanced hepatic fibrosis and cirrhosis has generally been considered to be irreversible. The aim of this study was to determine whether cirrhosis is reversible.Methods: Seven patients with AUTOIMMUNE HEPATITIS with histologic evidence of cirrhosis were enrolled. After treatment, they had follow-up liver biopsy while in clinical and biochemical remission. Biopsy specimens were randomly coded in unpaired manner according to patient and were read independently by two pathologists using the modified HEPATITIS activity index (with a maximum stage of 6).Results: Three patients still had extensive fibrosis in the second liver biopsy. But four patients had almost total regression of their liver fibrosis. In the latter patients, the mean alanine aminotransferase level decreased from 776.3 U/L to 23 U/L. The mean bilirubin level decreased from 5.85 mg/dL, to 0.98 mg/dL. Extensive fibrosis or cirrhosis were present in all patients at diagnosis but were not present on follow-up liver biopsy. The mean fibrosis score decreased from 5.88 to 0.5 (P=0.0002), and the mean grading score from 11.38 to 2.5 (P=0.0008.).Conclusion: Frank cirrhosis due to AUTOIMMUNE HEPATITIS may be reversible in some patients who respond to treatment.

 Background: AUTOIMMUNE HEPATITIS (AIH) is a self-perpetuating hepatocellular inflammation of unknown cause. It is characterized by the presence of interface HEPATITIS on histologic examination, hyper gammaglobulinemia, and autoantibodies in serum. This study was performed to determine clinical and laboratory profile of AIH in Iran.Methods and Materials: The medical records of patients with AIH from 4 gastroenterology clinics in Tehran were retrospectively reviewed from September 1988 to May 2003. Forty-six patients with AIH whose medical records were complete were selected for final review. Results: Of the 46 patients, 38 (82%) were female. The median age at presentation was 24 years. All patients fell into the category of AIH type-I. Seventeen percent had associated AUTOIMMUNE diseases with diabetes type-I and AUTOIMMUNE hemolytic disease being more common. The onset was acute in 5% and chronic in 87% with the remaining 8% being asymptomatic. The most common symptoms were icterus (59%) and fatigue (33%) and the most common signs were splenomegaly (33%) and hepatomegaly (30%). In all cases, HBV and HCV serum markers were negative and serum levels of ferritin and copper were within normal limits. High serum levels of AST, total billirubin and alkaline phosphatase were detected in 93%, 39% and 74%, respectively while hyper gammaglobulinemia was found in 67%. SMA, ANA, PANCA and AMA were positive in 50%, 37%, 4% and 13%, respectively.Conclusions: AIH type-I is more common in Iran than in the United States and Europe and other types are seen rarely. Younger age at presentation, less frequent acute onset disease and lower rate of autoantibody positivity and hyper gammaglobulinemia may merit attention.    

Aim: The aim of this study was to review our experience with gestations in AUTOIMMUNE HEPATITIS patients.Background: There are only limited data describing pregnancy in patients with AUTOIMMUNE HEPATITIS. Patients and methods: Retrospective analysis of pregnancies with AUTOIMMUNE HEPATITIS followed in Centro Hospitalar do Porto, Portugal in the last ten years.Results: We reported nine pregnancies in seven patients with AUTOIMMUNE HEPATITIS. Two patients had documented liver cirrhosis prior to the pregnancy. In this study, 66.7% of patients were treated with azathioprine and 88.9% with prednisolone. Clinical improvements were observed in 11.1% of pregnancies and 22.2% exacerbations were diagnosed. There were six live births and two preterm deliveries (preterm delivery rate of 33%). We also report three first trimester miscarriages (early gestation miscarriage rate of 33%). There were no neonatal or maternal deaths.Conclusion: The favorable obstetric outcome is a realistic expectation in patients with AUTOIMMUNE HEPATITIS. Tight monitoring and control of asymptomatic and unpredictable exacerbations, which are unrelated to the severity of the underlying disease, are essential to the prognosis of the current pregnancy.

Background: Occult HEPATITIS C virus infection (OCI) is recognized by finding HEPATITIS C virus (HCV) RNA in hepatocytes without detectable anti-HCV antibodies and viral RNA in plasma. AUTOIMMUNE HEPATITIS (AIH) is a chronic and generally progressive disease without exactly-identified etiology.Objectives: This study aimed to determine the prevalence of OCI among patients with AIH and to evaluate the tests used to rule out HCV infection in diagnosing AIH.Patients and Methods: Between July 2012 to February 2013, 35 Iranian patients with AIH who attended Tehran HEPATITIS Center were investigated. For identifying OCI, detection of HCV RNA in both ultracentrifuged serum samples and peripheral blood mononuclear cells (PBMCs) was used. Data analysis was performed using SPSS.Results: Six males and 29 females with mean disease duration of 77.1±39.5 month and mean age of 43.62±12.67 years were investigated. All cases were negative for anti-HCV antibody and we could not find any HCV RNA in ultracentrifuged serum samples and PBMCs.Conclusions: With our laboratory diagnostic method, it seems that there are no cases of OCI in patients with AIH. However, we recommend further studies with more samples and more precise laboratory method.