Autoimmune hepatitis in Hepatitis C, what to do?

Question: What is the gold standard for diagnosis? Can steroid therapy be instituted on clinical evidence alone? And how best to treat it when steroids cause a deterioration of hepatic function by promoting viral replication? Is a combination of peg interferon and steroids justifiable in such patients? Can anyone give me a few good references that I can check on the web?

Answers:
Sorry you have been diagnosed with both liver diseases. Many of us with HCV have more than one type of liver disease, mine is NASH although the HCV is gone.

In general, if the HCV infection were predominant and the autoimmune hepatitis mild, alfa interferon treatment would be considered. However, if the autoimmune hepatitis were severe, leading to such complications as kidney damage, rashes, or rapid liver failure, steroids or other immunosuppressant drugs would more likely be recommended.

The choice between these treatment options boils down to the immune system. Alfa interferon, which activates the immune system to reduce viral replication, could be problematic for those whose immune system was already over-activated due to severe autoimmune hepatitis. Steroids, which suppress the immune system, could be problematic for those with severe HCV-infection, leading to a compromise the body's ability to fight the infection.

Other Answers:
contact me. I will be starting treatment soon.

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The gold standard will included a HCV RIBA, HCV-PCR QN, and HCV-genotype. The HCV RIBA is a confirmatory test for HCV, and the PCR test will tell you the number of virus in your blood, and lastly HCV genotype will determine the genotype of HCV virus. You should have PCR test done on a regular basis to determine your viral load to ensure the medication is working properly.

Go to

http://www.labcorp.com/dos/index.html

Then search type in either hepatitis C, or HCV and almost all known lab tests related to HCV will pop up.

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