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cirrhosis v/s chronic active hepatitis

cirrhosis v/s chronic active hepatitis

Sir/Madam,
My father 60 year old non hypertensive non diabetic
has complaints of :
pedal edema since a year
was investigated - found to have ascites + abnormal liver function tests in June 2002.
He has a history of Hepatitis B infection in 1986 but was seronegative after that and had was asymptomatic till April 2002 when he had a sudden dislike for coffee.

Has been under treatment with rest + diuretics + protein restriction due to early hepatic encephalopathy stage 1.

On further investigations repeated every 15 days now has raised prothrombin timeINR 3 and decreased Albumin 2.1.
Also recent tests showed antiphospholipid antibody both against cardiolipin and lupus anticoagul;ant to be positive.

Liver biopsy avoided till now because of raised prothrombin time. Anti microsomal AB negative

There is a dilemma of -
whether it would be safe to proceed with liver biopsy may be after administering fresh frozen plasma
Can medications be tried without biopsy
What would be further management in such a case especially how to rule out autoimmune hepatitis considering anti phospholipid antibody and role for steroids & immunosuppressives in such a case.

What is the long term prognosis in such a case
Please do reply

Dhabuli.
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