Autoimmune Hepatitis (AIH) Panel: Test Details, Purpose & Precautions
The Autoimmune Hepatitis (AIH) Panel includes specific autoantibody tests used to diagnose Autoimmune Hepatitis, a chronic liver disease where the body’s immune system attacks liver cells. This can lead to liver inflammation, fibrosis, and cirrhosis if left untreated.
1. Tests Included in the AIH Panel
🔹 Anti-Smooth Muscle Antibody (ASMA)
- Detects antibodies against actin and smooth muscle.
- Positive in AIH Type 1 (most common form).
- Also found in primary biliary cholangitis (PBC) and viral hepatitis.
🔹 Anti-Mitochondrial Antibody (AMA)
- Main marker for Primary Biliary Cholangitis (PBC), but may be positive in AIH.
- Helps differentiate PBC from AIH when both conditions are suspected.
🔹 Liver-Kidney Microsomal Antibody (LKM1)
- Specific marker for AIH Type 2 (more severe, often in children/young adults).
- Helps distinguish AIH Type 2 from viral hepatitis.
🔹 Antinuclear Antibody (ANA)
- Found in AIH Type 1, but also in lupus, PBC, and other autoimmune diseases.
- Not specific to AIH but supports diagnosis when combined with other markers.
2. Purpose of AIH Panel
✔ Diagnoses Autoimmune Hepatitis (Type 1 & Type 2).
✔ Differentiates AIH from Primary Biliary Cholangitis (PBC) and other liver diseases.
✔ Identifies AIH early to prevent progression to cirrhosis.
✔ Monitors disease activity and response to treatment.
3. Interpretation of AIH Panel
| Test | AIH Type 1 | AIH Type 2 | Primary Biliary Cholangitis (PBC) | Viral Hepatitis |
|---|---|---|---|---|
| ASMA | ✅ Positive | ❌ Negative | ❌ Negative | ❌ Negative |
| AMA | ❌ Negative | ❌ Negative | ✅ Positive (Primary Marker) | ❌ Negative |
| LKM1 | ❌ Negative | ✅ Positive (Specific Marker) | ❌ Negative | ❌ Negative |
| ANA | ✅ Positive | ❌ Negative | ✅ Sometimes Positive | ❌ Negative |
✅ AIH Type 1: Positive ASMA & ANA (most common, responds well to steroids).
✅ AIH Type 2: Positive LKM1 (more severe, often in younger patients).
✅ PBC: Positive AMA (can mimic AIH but has different treatment).
✅ Viral Hepatitis: All autoantibodies negative, need viral markers (HBV, HCV).
4. Precautions & Preparation for AIH Panel
✔ No fasting required for antibody testing.
✔ Inform your doctor if you have other autoimmune diseases (SLE, PBC, Hashimoto’s) as they can cause false positives.
✔ Liver function tests (ALT, AST, ALP, Bilirubin) are often done together to assess liver damage.
✔ Liver biopsy may be needed to confirm AIH and assess fibrosis.
