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Autoimmune hepatitis (AIH)-related hepatocellular carcinoma (HCC) is defined as HCC that develops on the basis of long-term AIH and has a relatively low incidence rate of 0-6%. The risk factors for HCC in AIH patients include old age, male sex, diabetes, alcohol use, AIH recurrence and persistent alanine aminotransferase abnormalities, failure in immunosuppressive therapy and related treatments, and long-term liver cirrhosis. Liver cirrhosis is an important stage for the development of HCC in AIH, and the incidence rate of HCC increases significantly after AIH progresses to liver cirrhosis. At present, there are few reports on the mechanism of HCC in AIH, which may be associated with the changes in specific molecular biological characteristics (including chromosomes, telomeres, and genes) induced by liver cirrhosis, the cell death-inflammation-cancer pathway, and intestinal microecological disorders. It is of great importance to identify the AIH population at a high risk of HCC in a timely manner and enhance intervention, follow-up, and monitoring.
