517294?1212081606
Douglas Dieterich, MD  
Male
New York, NY

Specialties: Internal Medicine, Gastroenterology

Interests: Hepatitis C, HIV-Related Liver Disease

The Mount Sinai Medical Center
877-241-4983
1190 5th Avenue
New York, NY
My Posts
Help understanding Hep C treatment
Mar 10, 2009 in the Hepatitis Expert Forum
It sounds, as you can tell from the above responses that your Mom's reaction is not atypical of people taking interferon. It also sounds like she could benefit from an antidepressant that will help her sleep and give her more energy. We also use Provigil to perk people up for a few hours at a time so that they can concentrate. We encourage light exercise, lo...
Hep C & anabolic steroids
Mar 03, 2009 in the Hepatitis Expert Forum
It is generally safe to take injected steroids (if you need them) with chronic HCV. It may be much less safe during the acute event, which you are now experiencing. If your ALT is normal and the HCV RNA is < 600 at week 12 then it will probably be OK to take the injectables only, not the oral steroids. The reason is that the injectables do not go through t...
Hep c
Feb 23, 2009 in the Hepatitis Expert Forum
Ammonia is sometimes used as a sign of encephalopathy. If your husband is confused and disoriented and the ammonia is high and correlates with those symptoms, then it can be a useful guide. Other than in those situations, it does not really mean a great deal. If his mental state is OK then forget about the ammonia level, it is not pertinent. Good luck with hi...
hep c test
Feb 11, 2009 in the Hepatitis Expert Forum
You are out of the woods. I dont think you need to worry now about any other HCV testing. You should however make sure your hepatitis A and B antibodies are up to date and get a booster vaccine if they are not.Stay safe and well! DTD
Hep C w/cirrhosis
Feb 04, 2009 in the Hepatitis Expert Forum
It sounds like your brother by definition is already a Childs B if he has ascites and likely has varices if the doc is recommending a TIPSS. He needs to be at a transplant center before anything else is done at all. The advocate is correct about MELD score, but this is clearly decompensated cirrhosis and needs to be seen at a center where he can be evaluated ...
hepatotis testing and results
Feb 04, 2009 in the Hepatitis Expert Forum
Sorry it took so long to get back to you. You describe very low risk behavior so your risks of acquiring anything are very very low. It sounds like you have antibody to hepatitis A which you may have acquired in childhood and cleared so no you don't need to get vaccinated for hep A. If you don't have antibody to hep B, which it sounds like you don't then you ...
Relapsed, from Roche R1626/Prodrug
Feb 02, 2009 in the Hepatitis Expert Forum
I would wait as well with this one. This drug has had some bone marrow effects and they seem to last a long time. You may be able to qualify for a protease trial or one of the two proteases when they get approved in 2011. Certainly rushing to treat now would be a mistake. Take some time off and cure your liver, your marrow and your soul. then we can deal with...
Hepatits
Feb 02, 2009 in the Hepatitis Expert Forum
Quantitative test is more accurate and easier to diagnose false + results. HCV does not live at low levels unless it is on the way up or down. To be absoultely sure do quants 1 month apart. Good Luck! DTD
Am I at risk for Hep C?
Jan 26, 2009 in the Hepatitis Expert Forum
Then go get tested! stop worrying? and if you cant stop worrying then you need to seek mental health advice about how to control the anxiety! DTD
do I have Hepatitis
Jan 26, 2009 in the Hepatitis Expert Forum
The enzymes you show above are a chlestatic pattern, that is the bile is backing up. This can be due to physical blockage like a gallstone or other diseases of the bile ducts like PBC and PSC. The first step is an ultrasound to look at bile ducts, then blood tests to check for PBC, and PSC and then maybe a liver biopsy if no stones are found. Keep getting med...