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Cirrhosis and HIV (causes?)
Jan 12, 2003

Dr. Dieterich, I hope you can answer my question about possible causes of Cirrhosis of the Liver. I am poz, and also diabetic (32 years insulin dependent). I now have ascites, and a recent cat scan revealed I have stage II liver disease. My previous can scan in May of 2000 showed NO liver problems. So, my progression is greatly accelerated for some unknown reason. The usual causes do not apply to me. I do not drink alcohol. I do not have hepatitis A, B, or C. I have had Hep A and B in the past, even though I was not aware of it. I have fully recovered from both of those, and do not carry the virus now. I would be greatful for any information you can tell me. If there is something in my environment, or some medications or substances that might have caused this, perhaps I can stop the progression of this disease by identifying the culprit. My doctors are puzzled by my diagnosis.

Mark Sims

Response from Dr. Dieterich

You could have NASH from the diabetes or you could have a reactivation of HBV which can be diagnosed by doing an HBV DNA by PCR. The NASH can be diagnosed with a biopsy if it is not too risky. You could also have other things like hemochromatosis, alfa 1 deficiency and WIlson's disease, all unrelated to either HIV or diabetes. If your Cirrhosis is stage 2 (B) then I would also reccomend a consult with your closest transplant group that does HIV + transplants. They are Miami, Pittsburgh, San Francisco and Mt. Sinai in New York. Good luck! DTD

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