Autoimmune hepatitis (AIH) is an enigmatic, relatively rare disease with a variable spectrum of presentation whose pathogenesis, diagnosis and management remain a major challenge. Methods. We have performed a review incorporating recent developments in basic science, epidemiology, clinical science, therapeutics, regulatory science and evaluated the challenges associated with the application of translational research and clinical trial design to a condition that is a chameleon in nature, where outcomes range from relatively benign disease through cirrhosis and acute liver failure. This review is focused on developments from 2020 onwards so we can present a yet forward-looking view in the challenges and remaining questions necessary to improve patient care and outcome in AIH. We also outline areas of debate and offer insight into these areas.
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