For patients with autoimmune hepatitis under follow-up at Addenbrooke’s Hospital

Shielding

Patients with autoimmune hepatitis who take immunosuppression are considered to be at high risk of becoming severely ill from COVID-19. This means that they should be ‘shielding’ themselves from getting the infection, as described at the following web-link:

https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

We strongly recommend that you follow this advice. If you have any queries, get in touch (see below).

Treatment of your autoimmune hepatitis

As long as you do not have COVID-19, we recommend that you continue to take your immunosuppression as before. Reducing or stopping your immunosuppression might allow the autoimmune hepatitis to flare up, which is best avoided at this time.

If you develop COVID-19, however, we recommend the following short-term changes to your immunosuppression:

• If you take PREDNISOLONE at a dose greater than 5 mg once daily, double the daily dose of prednisolone for two weeks, and contact us (see below) at your earliest convenience for further advice;
• If you take PREDNISOLONE at a dose less than 5 mg once daily –increase the daily dose of prednisolone to 10 mg once daily for two weeks, and contact us (see below) at the earliest opportunity for further advice;
• If you take BUDESONIDE, continue to take it at the same dose, and contact us (see below) at the earliest opportunity for further advice;
• If you take AZATHIOPRINE – stop taking the azathioprine for a total of 2 weeks, and contact us (see below) at the earliest opportunity for further advice;
• If you take MYCOPHENOLATE MOFETIL – stop taking the mycophenolate mofetil for a total of 2 weeks, and contact us (see below) at the earliest opportunity for further advice;
• If you take TACROLIMUS – stop taking the tacrolimus for a total of 2 weeks, and contact us (see below) at the earliest opportunity for further advice;
• If you take CICLOSPORIN – stop taking the ciclosporin for a total of 2 weeks, and contact us (see below) at the earliest opportunity for further advice.

Contact details

If you have any concerns or queries about your autoimmune hepatitis, please contact us via MyChart, or using the phone number 01223 216110 (working hours only)