For those who want to view the actual lectures, you can sign up and view the recordings:  Aspen Webinar Lecture Series

Below I’ve included a few slides and some notes; my notes may have errors of omission or transcription.

COVID-19 and the Liver — Fred Suchy

Key Points:

• The extent and severity of liver disease related to COVID-19  is still being determined.  Many individuals have mild liver test abnormalities (5-60%)
• Avoid imaging unless it will change your management (eg. thrombus)
• In those with worsening/significant liver abnormalities, look for other etiologies of elevated liver tests (eg. other viral hepatitis, drugs, myositis, coinfection, clots, multi-system inflammatory disorder)
• Currently, no change in immunosuppression is recommended in the post-transplant population WITHOUT COVID-19. In those with severe COVID-19 infection, reduction in immunosuppression is recommended

How I Manage Patients with Autoimmune Hepatitis -Diagnosis and Treatment   Amy Taylor.

Key points:

• At presentation, check TPMT activity and look for other autoimmune diseases (especially thyroid, autoimmune hemolytic anemia, and celiac disease)
• Useful resource -C Mack et al Hepatology, May 2020 https://doi.org/10.1002/hep.31065 -full text link: 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
• Check cholangiography if not responding to treatment
• 1st line treatment: glucocorticoid with azathioprine.  Azathioprine dosing can be adjusted to aim for 6-TGN level 100-300.
• 2nd line treatment: mycophenilate mofitil (MMF).  3rd line treatment: calcineurin inhibitor
• Investigational therapies: infliximab, rituximab, regulatory T-cells