Autoimmune Markers and Hepatitis C

[Sumac]

I contracted Hepatitis C Type 1A from a needlestick injury at work. I do have some Autoimmune markers. ANA (+)  1:160;  ANTI ENA: Negative;  ANTI MA (+) 1:40  I have a positive family history for autoimmune markers. (MS, Lupus, Rheumatoid Arthritis)

Minimal inflammation on biopsy.

I want to start drug tx but am aware that it may 'stir up' whatever autoimmune disease for which I carry markers.
Can or should I be doing anything to check out these markers? My physician doesn't feel that I have autoimmune Hepatitis and seems disinterested in pursuing what the markers mean.
Should or can I do anything more to know what I am risking if I need drug tx?
What should I be doing to check out these markers?

I appreciate the advice.

[nurse12hr]

I have a question:  Are you being covered by workers comp due to contracting this by needlestick injury at work?  Just nosy.

[Galen]

If I were you, I would definitely get checked out by a rheumatologist prior to starting tx, and then regularly during tx.  If you hep doc is not willing to work with another doc, I would find a new hep doc.  Autoimmune diseases are nothing to blow off.  You may indeed find that you have nothing to worry about, but it is always a good idea to monitor the situation.  Autoimmune diseases can be made worse by tx, but someone here posted that their RA actually improved on the meds.

[chicagogirl]

I would definately go to a top notch hepatology team, at a teaching hospital, with a large HEPC population.  I am currently in treatment and have read, over and over, that people with any autoimmune disorders, should not take interferon.  This might apply in your case, as someone with potential autoimmune disorders.  Get a second opinion.  It is too important a decision.

[pat57]

it sounds like you have no damage, imflamation is not permanent, tho it is a precurser. IMO you need to learn to live liver freindly. I would not even consider treatment with minimal inflamation (inflammation). It is true that when caught early, within the first year, possiblly even less time, the response rate goes up. You need to get statistics. I believe its 15% of folks kick up immune problems, and thats without haveing prior known markers. You absoultly need to have info on your scenio. Do you realize how slow HCV typically progresses? Unless I misunderstand your biopsy report- or you do- you've got tons of time. Let medicine fine tune treatment before you go on it. Also if they cannot already asess your risk they will soon be able too. If someday because of moderate to serious liver damage you take the risk, thats one thing. But now?

WHY? RA and Lupus are hard to live with, HCV is not. This is why it is called the silent killer. Folks typically have it for 20 years before they know something is wrong. And then its fatique. RA & Lupus patients would love to just have fatique!

IMO

you should have a sed rate done too- if you haven't. MS may not present a problem, they treat that with interferon gamma so I don't know if interferon alpha, what we get, would be a problem.
heavens, you should find out tho!

[willing]

agree with previous comments - there may be clear grounds to rule out auoto-immune hep (though not apparent to me as a layman, based on the results you listed, see <a href="http://www.aruplab.com/guides/clt/tests/clt_al80.htm#2480172">aih diagnosis</a>. However, the ANA and AMA tests may be indicative of another autoimmune issue. As pat points out if your fibrosis is minimal, starting tx may mean trading a slow-progressing, easily tolerated condition for a much worse one. Here's a <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12528081&dopt=Abstract">study</a>that backs up the drug company warnings of autoimmune complications. Getting a good rheumatologist's  opinion on the safety of starting IFN treatment seems like a really good idea.

[aaapattie]

As someone with Autoimmune Hepatitis I would NEVER even consider Hep C treatment without PROOF that I did NOT have an autoimmune problem.  PLEASE get more advice before making any treatment plans!  God Bless.  Pattie

[layla]

My daughters roommate (Sara) in college for the last 3 years has autoimmune hepatitis. Through the years my daughter (Lea) has made sure they have the right foods in the  house and prods her friend to take good care of herself and get enough rest. She was just diagnosed at the beginning of college (4 years ago)and having a hard time accepting this dx. My daughter graduated and has moved out now.  The problem is her fried told her a couple days ago she's very sick and it's like when she was first dx. We are now very concerned because she doesn't take very good care of herself on her own. She has not told her mother becasue she fears she will freak out and be running over there. Which she probably will. (They do get along). I'm not sure what to do but having the disease do you think we should tell her mother? Lea is calling her daily to see how she is and prompting her to go to the doctors but Sara has had to be hand held to go to the docs before. We know SAra and think she is just trying to get through the next 6 months to graduation so she not telling the docs. I am not sure how serious this is since I don't understand the disease so well. Would you mind sharing your thoughts on this. We would be very appreciative for any comments you might share. I a bit afraid for this young gal.

[aaapattie]

I'd be happy to help Sara if I can.  She sounds like me when I was diagnosed.  I too tried to ignore it.  Also, I sure understand the mother part.  My mother and I are very close.  I just got off the phone with her in fact.  She called to make sure I slept well last night because I "looked tired" yesterday.  :-)  Mom's are great, but they can overload you when you are sick.  lol  Why don't you give me a holler on email so we don't take up a bunch of space here for the Hep C guys.  

[e-mail]   I've had this address for years so I get LOTS of junk mail.  Please put  Autoimmune Hepatitis  in the subject area so I don't delete you with the masses.  Thanks!

Pattie

[aaapattie]

By the way ... this is NOT something to ignore.  This disease can result in death and she can be to a place too far to fix before she has many physical problems to realize it.  I'm thankful for Sara that you are concerned.  She needs you.  God Bless.  Pattie

[aaapattie]

I've found my email server is having problems and I'm not getting some of my email.  With it being a holiday the repair may take longer than normal.  If you should email me and don't hear from me within 24 hours, please resend your message.  I may not have received it.  Thanks.  Sorry.  Pattie

[aaapattie]

I got your email.  Tried to return a reply.  The message keeps coming back to me as undeliverable.  It could still be a problem with my email server, but wanted you to know just in case you wanted to send again and I can check your address.
Pattie

[layla]

I'll send another. I'll check here if I don't hear back from you then post you an email adress here if I need to. Thanks so much. LL