The Immune System and Its Role in Hepatitis

The immune system is a collection of organs, cells, and tissues that work together to protect your body from pathogens (such as bacteria, viruses, parasites, and fungi) that can cause disease. It’s a very complex defense system that not only helps your body respond to infectious diseases (sometimes with help from immunizations), but it can also cause trouble in the form of allergies and autoimmune diseases.

Autoimmune diseases are the result of a process in which the immune system mistakes an organ or body system for an invader, and attacks it as such. This results in inflammation and damage to the organ.

Woman getting a physical
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Autoimmune Hepatitis

The immune system is involved in one way or another in patients with many types of hepatitis, which is an inflammation of the liver. For people with chronic viral hepatitis, the immune system attacks the virus and the resulting long-term inflammation can cause damage to the liver.

Autoimmune hepatitis, when the body’s immune system mistakes normal liver tissue for an invader and attacks accordingly, is a chronic disease that causes inflammation and liver damage. If left untreated, autoimmune hepatitis can worsen over time and lead to cirrhosis and liver failure. The disease can cause symptoms that resemble those of viral or other types of hepatitis such as:

  • Fatigue
  • Joint pain
  • Nausea
  • Loss of appetite
  • Pain or discomfort over the liver
  • Skin rashes
  • Dark yellow urine
  • Light-colored stools
  • Jaundice, or yellowing of the skin and whites of the eyes


There are currently two vaccines to prevent against two different types of viral hepatitis—hepatitis A and hepatitis B. Vaccines, or immunizations, use a trigger (such as inactivated or weakened viral material) to create an immune response against the invader. The immune system then essentially has a developed and effective response available when a true pathogen becomes a threat.


For patients with autoimmune hepatitis, the goal of treatment is to prevent liver damage that occurs as a result of the immune system’s assault on the liver. One way modern medicine is able to achieve this goal is by using treatments, such as steroids or steroids plus azathioprine, that suppress the immune system to help prevent further damage.

2 Sources
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  1. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of autoimmune hepatitis.

  2. Mack CL, Adams D, Assis DN, et al. Diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American Association for the Study of Liver Diseases. Hepatology. 2020;72(2):671-722. doi:10.1002/hep.31065

By Charles Daniel
 Charles Daniel, MPH, CHES is an infectious disease epidemiologist, specializing in hepatitis.