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autoimmune

what is that type of hepatitis, iam so confused..
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Avatar universal
Excellent point.  Spot on.
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Avatar universal
Given the fact that she's failed treatment, in general I'd opt for a second consult even without whatever complications she might be having now. Docs are people, and can carry baggage from prior treatments. Of course if "sf" has a cracker jack hepatologist she is comfortable with, then by all means stay the course. I say, why wait -- get a consult now, if logistically feasible.
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Avatar universal
Re Jim's comment on a hepatologist:  I'll wait to see what your status is .. if they've given you AIH as a diagnosis or if they've mentioned they're testing for this....if it's a confirmed diagnosis, by all means, get the best possible care which means an experienced hepatologist...which is what you want anyway with HCV but particularly if you've got both.  Here's hoping for you this is routine testing .. and negative.

Trish
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Avatar universal
# Autoantibodies: Autoimmune hepatitis is characterized by positive findings on autoantibody tests (see Pathophysiology). Autoimmune hepatitis type 1 is characterized by positive test results for ASMA and ANA. Type 2 disease is observed infrequently in the United States, but it is well characterized in Europe. Type 2 disease is marked by a positive test result for anti–LKM-1 antibody. Type 3 disease also is observed infrequently in the United States. Type 3 is marked by a positive test result for anti-SLA antibody.
Serum protein electrophoresis and quantitative immunoglobulins
  * An immunoglobulin G (IgG)–predominant polyclonal hypergammaglobulinemia is a common finding in patients with untreated autoimmune hepatitis. Gamma globulin values typically range from 3-4 g/dL and frequently are as high as 5-6 g/dL. Cases of hyperviscosity syndrome secondary to high IgG levels are reported. Autoimmune hepatitis is an unlikely diagnosis in patients who have acute hepatitis without hypergammaglobulinemia.
    * The gamma globulin or the IgG level may be followed on a regular basis as a marker of disease responsiveness to therapy.

Liver biopsy is the most important diagnostic procedure in patients with autoimmune hepatitis.# This procedure can be performed percutaneously, with or without ultrasound guidance, or by the transjugular route. The latter is preferred if the patient has coagulopathy or severe thrombocytopenia. A transjugular liver biopsy also may be preferable if ascites is present or if the liver is small, shrunken, and difficult to reach percutaneously. Liver biopsy routinely is performed in the outpatient setting to investigate abnormal liver chemistries. Liver biopsy should be performed as early as possible in patients with acute hepatitis who are thought to have autoimmune hepatitis. Confirmation of the diagnosis enables initiation of treatment at an early stage in the disease process.
The role of biopsy in patients presenting with well-established cirrhosis secondary to autoimmune hepatitis is less clear. As an example, the initiation of treatment in a patient with cirrhosis, normal aminotransferase levels, and a minimally elevated gamma globulin level is not expected to influence the disease outcome.

http://www.emedicine.com/med/topic366.htm
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476246 tn?1418870914
I just wanted to ask what the test is, to determine if one has AIH. Is it the ASMA test? We have another forum member, Gehadoski,  asking about a positive ASMA test and one of his doctors said he couldn't treat the other one said that it had nothing to do with HCV. He has not been explained what a positive ASMA test means. He is in Egypt and concerned that his docs don't know what they are talking about. If someone would be so kind to chime in on his question, it would be really nice.

Thanks, Marcia
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Avatar universal
From memory -- so please double check and in fact we had a recent thread on this where I believe an article was posted -- you can have either HCV or Autoimmune, or you can have both at the same time.

If you have both, then a decision has to be made which one to treat/manage and that has to do with how much of a threat  each respective condition is. In any event, having both you really need a liver specialist (hepatologist) to sort the whole thing out because it's not simple. Therefore, if you're seeing a GP or a Gastro, you might seriously consider getting a referral to a hepatologist. They can usually be found at your larger, teaching hospitals.
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Avatar universal
I'm thinking it's a precautionary measure, Sandy.  I think it's a good thing they're checking for this.  In rare cases, interferon treatment can result in autoimmune hepatitis for persons with Hep C and when your ALT and AST go up like that, they should check various things to rule them out.  Same as when I went for my thyroid test ... they're looking to rule out Graves Disease even though the possibility is remote.  It still exists.  You try not to let that get ahold of your thinking .. you don't have it til they say you do, after all.

So I'm hoping that's what they're doing with you .. ruling things OUT.  And that's a good thing if they're being thorough.

Let us know how it goes, okay?  I'm rooting for you.  Hang in there.

Trish
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Avatar universal
You asked: "i wonder if u can have one and not the other?  or have autioimmune and not other.. Iam really scared now "

Yes is is possible to have either disease without the other. If you have only HCV you treat it with the current treatment or one of the drugs in trial. If you have autoimmune hepatitis generally steroids or other immunosuppressive drugs are used. And it is possible to have both diseases which presents a much more difficult situation. With both diseases treatment for hep c with the standard drugs often worsens the autoimmune hepatitis. The autoimmune hepatitis is the result an immune response and interferon stimulates the immune system. And if you treat the autoimmune hepatitis then the immune suppressive drugs may worsen HCV. This makes it very difficult to treat or maybe "manage" would be a better word.
Mike
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Avatar universal
thanks everyone
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Avatar universal
had a biospy last year and was stage 2 and grade 2 and viral was 2 million then somewhere between 12 and 24 weeks i became und  and then went to 48 weeks. couldnt go to 72 weeks. cause i was on research and they wouldnt allow it.so after off tx after 48 weeks within  4 weeks viral was 91  only... Then a week after that they recheck me and ast and alt in the 200... what the heck.... any suggestions...
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206807 tn?1331936184
I don’t know a lot about Autoimmune Hepatitis but I think I read Autoimmune Hepatitis can cause a False Positive in HCV testing.
Maybe your Doctor wants to be sure. Regardless, there is no reason to panic over a test.
You gave no other information about your HCV other than you have it. I am curios, did you find out you have HCV from a Blood Bank?
We have several people on this forum that is far more knowledgeable than I am and I am sure they will respond soon.
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Avatar universal
i wonder if u can have one and not the other?  or have autioimmune and not other.. Iam really scared now
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Avatar universal
okay...they are checking me for that..i already have hepatitis C
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547836 tn?1302832832
i believe it's where self immune system can't recognize some of the liver cells as "self"  instead they recognize it as a foreign substance and attacks the tissue thus giving hepatitis.
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