rejection vs hepc

My husband had a liver transplant 2 years ago, he was a nonresponder to interferon treatment. His liver enzymes went way up and ggt also. He had a biopsy and it came back both rejection and hep c attacking the liver. My question is if the enzymes go down after he takes more rejection medicine how will we know if the hepc is attacking or it still is rejection. Does it go by GGT level? One more question are there any trials for post transplant patients for treating hepc, I know they have them for nontransplant patients. Thank you, Ruth

[Thomas D Schiano, MD]

unfortunately there are no trials for HCV post-liver transplant aside from different algorithms using interferon.  sometimes frequent liver biopsies are necessary to differentiate rejection and recurrent HCV as the treatments for rejection and HCV are totally opposite.