Autoimmune hepatitis and pregnancy:considerations for the clinician

Introduction: Autoimmune hepatitis (AIH) is an immune-mediated inflammatory disease of the liver, which affects females of reproductive age. AIH poses unique challenges in pregnancy and historically was associated with adverse pregnancy outcomes. Areas covered: This report aims to review the current evidence for AIH pregnancy outcomes and the use of medical therapies in pregnancy. The disease course of AIH in pregnancy including loss of biochemical response (LOBR) and hepatic decompensation is also reviewed. The importance of preconception counseling and continued monitoring into the post-partum phase is reinforced. Expert opinion: The lack of prognostic markers and targeted immunosuppression is some of the areas for future development, as this will aid the move toward individualized risk stratification and personalized care.