Cirrhosis of the Liver Community
Auto Immune Hepititis(hepatitis) & STG 4 Cirrhosis of the Liver
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Cirrhosis is the end result of chronic liver damage caused by chronic liver diseases. The purpose of the community is to share support and information with Cirrhosis of the Liver patients and their loved ones. Topics in the community include: causes, clinical trials, complications, family issues, living with Cirrhosis of the Liver, prognosis, research, surgery, treatments

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Auto Immune Hepititis(hepatitis) & STG 4 Cirrhosis of the Liver

I have had Auto Immune Hep for 9 years now. I recently had a transjugular biopsy and I was told it shows I am in Stage 4 Cirrhosis of the Liver.  My previous Biopsy 3 yrs before showed I was at stage 0-1... I have been taking medications and see my doctor on a regular basis... How can I advance so fast undetected and now that I am in stage 4 how long can will it be before my liver fails completely.  
Tags: AIH Cirrhosis
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Hello Gulia and welcome to MedHelp.

Whatever type of autoimmune hepatitis you have, the goal of treatment is to slow or stop your body's immune system from attacking your liver. This may help slow the progression of the disease. You should be seeking treatment from a liver transplant center if you are not already. Even if you do not need a transplant you will receive the best treatment available. Any other doctor even though their intentions are good just isn't qualified enough to treat your cirrhosis. Preventing or slowing the progression is critical. Chicago has many to choose from:


Loyola University Medical Center

Maywood, IL

(708) 216-9000

Northwestern Memorial Hospital

Chicago, IL

(312) 926-2000

Rush University Medical Center

Chicago, IL

(312) 942-5000

University of Chicago Medical Center

Chicago, IL

(773) 702-3000

University of Illinois Medical Center

Chicago, IL

(312) 996-7000


Medications to control your immune system (immunosuppressants)
Medications used to treat autoimmune hepatitis include:

Prednisone. Doctors usually recommend an initial high dose of the corticosteroid drug prednisone for people with autoimmune hepatitis. The medication is reduced to the lowest possible dose that controls the disease over a few weeks. Most people need to continue taking the prednisone for at least 18 to 24 months, and some people remain on it for life. Although you may experience remission a few years after starting treatment, the disease often returns if the drug is discontinued.

Prednisone, especially when taken long term, can cause a wide range of serious side effects, including diabetes, thinning bones (osteoporosis), broken bones (osteonecrosis), high blood pressure, cataracts, glaucoma and weight gain.

Azathioprine (Azasan, Imuran). Azathioprine, another immunosuppressant medication, is sometimes used along with prednisone. Using both medications may allow you to take a smaller dose of prednisone, reducing its side effects. Side effects of azathioprine may include difficulty fighting infections and nausea. Rare side effects include liver damage, pancreas inflammation (pancreatitis) and cancer.
Other immunosuppressants. If you don't respond to prednisone or azathioprine, your doctor may prescribe stronger immunosuppressants, such as mycophenolate (CellCept), cyclosporine (Neoral, Sandimmune, others) or tacrolimus (Prograf).
When medication fails to stop the progression of cirrhosis eventually a liver transplant must be considered. This is another reason to also seek treatment with a transplant facility.

There are also many other things you should avoid that can cause your cirrhosis to advance more rapidly such as:

Don't drink alcohol. Whether your cirrhosis was caused by chronic alcohol use or another disease, avoid alcohol. Drinking alcohol may cause further liver damage.

Eat a low-sodium diet. Excess salt can cause your body to retain fluids, worsening swelling in your abdomen and legs. Use herbs for seasoning your food, rather than salt. Choose prepared foods that are low in sodium.

Eat a healthy diet. People with cirrhosis can experience malnutrition. Combat this with a healthy plant-based diet that includes a variety of fruits and vegetables. Choose lean protein, such as legumes, poultry or fish. Avoid raw seafood.

Avoid infections. Cirrhosis makes it more difficult for you to fight off infections. Protect yourself by avoiding people who are sick and washing your hands frequently. Get vaccinated for hepatitis A and B, influenza, and pneumonia.

Use over-the-counter medications carefully. Cirrhosis makes it more difficult for your liver to process drugs. For this reason, ask your doctor before taking any medications, including nonprescription drugs. Avoid drugs such as aspirin and ibuprofen (Advil, Motrin IB). If you have liver damage, your doctor may recommend acetaminophen (Tylenol, others) in low doses for pain relief.
" How can I advance so fast undetected"
Normally for persons with cirrhosis imaging (CT Scan or Ultra Sound) is performed every 6 months and lab testing is done every 3 months monitoring the health of your liver. As your disease progressed you should have been informed and more aggressive treatment should have been pursued.

"I am in stage 4 how long can will it be before my liver fails completely"
As you can see it's difficult to answer this question since there are many variables to consider. This page very well explains why although I personally do not always agree with statistics the rest I hope will help you understand. In stage 4 we have compensated and decompensated symptoms, knowing the different symptoms will help you gain a better idea. Keep in mind all test result are an important factor.

I wish you all the best,

Thank you for all the information you provided.  I am seeing a Hepatologist at Rush and she did say she needed to run more tests before we approach transplant as the next step.  I have been taking predisone and mycophenolate for the past 9  yrs and until the biopsy I thought everything was status quo.  

Again thank you for all the information.

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