Transient exacerbation after infections in patients with autoimmune hepatitis

Shigeo Maruyama, Masahiko Koda



Although the pathogenesis of autoimmune hepatitis (AIH) is unknown, many recent studies have demonstrated that infection can act as a trigger for the onset of AIH. The existence of a pathogenetic link between AIH and infections has not been confirmed. If AIH is triggered by infections, it is possible that infections may transitorily worsen liver function in patients with AIH. We investigated the association between the effects of infections and the exacerbation of liver dysfunction in patients with AIH.


We determined the changes in liver function before and after infections in 20 patients with definite AIH, 33 with probable AIH, 24 with primary biliary cholangitis (PBC), 30 with chronic hepatitis C (CH(C)), and 23 control subjects.


During the study period, 19 of the 20 patients (95%) with AIH experienced one or more signs ofliver dysfunction after infection. Seventy-three (59%) out of the 124 total occurrences of infectionsin 19 patients met the criteria for transient exacerbation of liver dysfunction. The incidence of liver dysfunction and the serum IgG levels after infection were significantly higher in the patients with definite AIH than in the patients with probable AIH, PBC and CH(C), and in the control subjects. Serum IgG level was a significant independent predictor of liver dysfunction.


The present study results suggested that infection was one cause of exacerbation of liver dysfunction in patients with AIH, and that serum IgG level was a significant independent predictor of exacerbation of liver dysfunction after infection.


liver dysfunction, autoimmune hepatitis, exacerbation, IgG



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