Wendy G. Clough, MD
Specialty: Infectious Disease
- infectious disease
- internal medicine
Location and Office HoursEllsworth Pryor III MD
23928 Lyons Ave Ste 208
Newhall, CA 91321
- Anthem BlueCross BlueShield
- Blue Shield of California
- BlueCross BlueShield
- Great-West Healthcare Cigna
- Health Net
- Inter Valley Health Plan
- LA Care Health Plan
- United Healthcare
- Henry Mayo Newhall Memorial Hospital
- Providence Holy Cross Medical Center
Should I get vaccinated for hepatitis C?
Honor Society of Nursing (STTI) answeredThere is no vaccine for hepatitis C. If you work in fields that require contact with blood such as the healthcare field or tattoo or piercing industry, you should protect yourself from contact with blood. Also avoid sharing needles, razors or other personal hygeine products, and practice safe sex if you have multiple partners.
What are infections?
Honor Society of Nursing (STTI) answered
Infections occur when harmful organisms enter your body and multiply, which then creates disease. Infections can be the result of many different types of organisms, such as viruses (viral infections), bacteria (bacterial infections), parasites (parasitic infections), or fungi (fungal infections). Because there are so many types of infections, they can present with many different symptoms and treatments.Helpful? 1 person found this helpful.
How is autoimmune hepatitis treated?
Patricia Raymond, MD, Internal Medicine, answeredThe treatment of autoimmune hepatitis is to turn down the immune system, so that it will stop chewing on the liver. Standard therapy is prednisone, a steroid, to decrease the immune response. To use less prednisone (as it can cause blood sugar elevations, cataracts, blood pressure problems, weight gain, osteoporosis, psychosis, and a host of other side effects), we add the drug azathioprine (imuran). Azathioprine has been used for years in transplant patients to suppress their immune systems so they will not reject their new organs and is also used for its "steroid sparing" effect (i.e., the ability to add some imuran to reduce the total dose of prednisone, to reduce those ugly side effects). Some folks with autoimmune hepatitis who cannot tolerate prednisone are on imuran alone.
Back when I was in training, circa 1992, we kept autoimmune hepatitis patients on immune suppression for life. Now the rules of the game seem to change on an annual basis, so make sure that your specialist has contacted his/her local hospital librarian to search the Internet archives of medical journals for the most current information to direct your treatment.
On to the current treatment -- now we seek to put you in "remission." Remission is defined as the liver tests being reduced to less than two times normal, which is reached in 80% of patients by three years. The dosages of the drugs, once remission is reached, are adjusted to give you the least amount of medications that you need to keep you in remission. After remission is achieved, first the steroids are withdrawn gradually over six weeks. If the steroids are removed without relapse (an upward bump in the levels of those liver enzymes), the azathioprine is carefully withdrawn.
About 50% of patients who achieved a response in liver tests remain in remission or only have mild activity after withdrawal of the initial treatment. The remainder "relapse" (the liver enzymes rise again), and are then retreated, then again carefully weaned from the medications -- over and over if necessary. Eventually 10% to 40% of patients who relapsed make it to remission, and they need no more medications but liver enzyme blood work (SGOT, SGPT) every two to six months. Those who don’t make it to remission without drug-free relapse may need to be on "maintenance therapy"; that is, low doses of steroids and/or azathioprine for life. However, the odds are strongly in your favor that you too will get into remission.Helpful? 1 person found this helpful.
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