Autoimmune hepatitis (AIH) is a chronic and often relapsing disorder. It is important that patients understand the positive benefits of achieving therapeutical remission and the comparative risks associated with inadequately treated disease.[1]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 Aug;72(2):671-722.
https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.31065
http://www.ncbi.nlm.nih.gov/pubmed/31863477?tool=bestpractice.com
Non-compliance or problematical adherence are commonplace among patients with chronic disease, particularly among adolescents.
Unwanted adverse effects of treatment such as weight gain, acne, raised blood sugar, high blood pressure, bone loss, gastric problems, mood and sleep disturbance, increased risk of infections, eye problems, and low white blood cell count should be discussed with the patient.
Hepatitis A and B vaccination, as well as yearly influenza vaccination, should be given to all patients with AIH.[26]European Association for the Study of the Liver. EASL clinical practice guidelines: autoimmune hepatitis. J Hepatol. 2015 Oct;63(4):971-1004.
http://www.ncbi.nlm.nih.gov/pubmed/26341719?tool=bestpractice.com
[81]UK Health Security Agency. Hepatitis A: the green book, chapter 17. Jan 2024 [internet publication].
https://www.gov.uk/government/publications/hepatitis-a-the-green-book-chapter-17
The hepatitis A and B vaccinations should ideally be administered prior to immunosuppressive treatment.[1]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 Aug;72(2):671-722.
https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.31065
http://www.ncbi.nlm.nih.gov/pubmed/31863477?tool=bestpractice.com