WARNING - Tx can trigger AIH

[sass_blue]

I had no idea that the above could happen.  I am geno 1 decided to start tx because I have had hep for 20 years.  Didnt really need to start tx as biopsy showed f1 but wanted to give it a go while relatively young (37) and healthy.  Tx'd for 12 weeks as a non-respsonder.   Stopped tx in January.  I was still feeling like **** 3 months after stopping so did investigative tests to discover my lft's have jumped to between 400 - 500, AFP 88 and I have been told I have AIH.  Only option is to take steriods which feeds the virus...cant try tx again either because of the AIH.  Pretty screwed really......I have 4 kids at home and had a great career ahead of me which has gone down the drain (spent five years at Uni as a mature adult student) Now I can work and while I looked 27 prior to tx I know look at least my age...Why arent we told about AIH being a risk?..I know I wasnt.

[SonicBandaid]

Yes, Bill.  Hepatologist with an interest in viral hepatitis as it turns out.  Don't practise in the US, tho', but once did. South of the Equator.  I suspect that there may be some very encouraging and exciting developments with HCV in the next 2-3 years, from what I have seen.
take it easy

[sass_blue]

great info thanks

[Bill1954]

Very interesting. By your comment above, are you a medical doctor? We could sure use one around here. Someone posted a link to the full-text study you referenced here recently:

http://www.virologyj.com/content/4/1/29

Thanks for stopping in. I hope you can return with more advice.

Bill

[SonicBandaid]

Hi, Look you may not be screwed!.  AIH does oftern need steroids, but then can frequently be managed with azathioprine (Imuran) alone.  Imuran has some (weak) activity agains HCV.  It is likely that once you AIH is controlled (and the reasons for it being triggered are contained in this article: Replicative homeostasis II: Influence of polymerase fidelity on RNA virus quasispecies biology: Implications for immune recognition, viral autoimmunity and other "virus receptor" diseases by
Richard Sallie; Virology Journal 2005, 2:70) your hepatologist MAY be able to restart your HCV treatment.  You may need stroids as well (that will increase the HCV levels), but if the interferon / ribavirin is effective it will probably overcome the effect of low-dose prednisolone.  I have treated some patients with AIH / HCV combination effectively like this.  It makes it harder, but not impossible; Don't Dispair!

[Bill1954]

Hi Sass,

I don

[goldyn]

Geez, sas so sorry to hear this, you treat this with steriods? how do you fight off the virus when your ready to treat again, I have heard of this, but do not know much about it, can you get rid of it? so you will just have your plain hepc again?
                           So Sorry , and God Bless
                                               Goldyn