The doc is right.

You can use twinvir. It is for type 1.

I am type 1a and I am going to use that

Hi Dr F and tweak max, Do you feel the Sofo/Led may be a little more gentle for most? I'm also GT1a and trying to decide. Does the How do DAC and LED differ ? Thanks

Hi London girl,

I will let u know the side effects once I start (hopefully soon)

What did ur doc recommend u?

After reading so many articles, I think if u can get your hands on either sof + dac or sof + led, just use either combination.

Hi TM, My Dr hasn't recommended me anything - I am in England
I will ask at next appointment.

hi LG,have a read of EASL HCV TREATMENT GUIDELINES 2015 SUMMARY.its a very clear and consise bit of info.sorry dont know how to do a link.

Do you have any info about twinvir and its effectiviness?

hey emilio, great post on that other ridiculous forum where you offered some much needed enlightenment. However as is customary there anything offering that kind of truth gets removed really fast. your post lasted about an hour before they wiped it. well written though. somebody on there realllllllyy doesn't want that kind of truth out there.

Hopefully those who really need help will find their way here like I did. The rest of that place seems to be all about people who have already been given trade name medicine for free and are all congratulating themselves for having been given free medicine. the censorship of news of alternatives for those who have been shut out of treatment is repulsive though. that place must be run by shills for pharma companies.

Thank-you Wilko, will revisit, have been waiting for Harvoni, but now there is the Sofo/DAC option.

Engle, I do hope you can get sorted out to help your Mother, God bless her.

Greg's posted an update on Mesochem company policy on his blog. It's the October 10 post:

hepatitisctreatment.homestead.com/generic-daclatasvir.html

The reality is simple.

We know we are giving too much treatment, but we must have a margin of safety.

We can only ever know we did not give enough treatment.

Why not 81 days? I like that number.

I actually give patients 90 days. Why - because the manufacturer had 36 g units of Sofosbuvir and 400 x 90 = 36 g.

Will those extra 6 days hurt - can't see how. Will they help? Well I'll tell you when the SVR12 data is available just after we present it at EASL in Barcelona next year.

You probably get hit by the rye grass pollen in Orange, emilio. I have a vague memory of them having asthma outbreaks from it up round Tamworth that were so bad they pushed the local hospitals to breaking point.

I've had the sniffles occasionally too. Initially put it down to a side effect until a neighbor said he had exactly the same thing on the same day. I only get mild hay fever. But as the wind was up that day, that side got pushed into the hay fever column.

I think James is going to put something else up about drug interactions when he gets the chance. For anyone who hasn't realised (like me), when you get the result from that drug interactions site, you can then click on the little symbol for more info. But it seems the DAAs are so new that site errs on the side of caution. It indicated oxycodeine might be a problem but I let them give it to me on the basis I knew Greg had codeine on the drugs and because I knew opiates are generally pretty benign. James rang the next day and said it was fine.

I can tell everyone not to expect doctors who don't normally treat hep c patient to have any clue whatsoever about treatment with the DAAs. Pretty funny having the emergency doctors waiting around for me to tell them what they could or couldn't give me.

I may have my first bona fide side though. I've got a bit of a rash on my abdomen. Now I do get heat rashes in this area but it's much more pronounced than usual. Weird thing is though, the heat rashes normally itch like hell but this isn't the least bit itchy. Haven't inspected it today yet cause I've got to get out of the sling to do so. But I figure if it's not in any way debilitating why be bothered by it.

In the absence of Ribavirin and with you feeling well:

Baseline: FBC, Cr&E, LFTs and Viral load are sufficient

4 weeks into treatment: LFTs and Viral load (expecting normal LFTs and zero viral load). This proves you have the right medication and that things are progressing as expected.

If your liver function is better and your viral load zero at 4 weeks into treatment you can stop testing. If not a repeat in 2 weeks would be sensible.

There is very little point in doing further testing once you are VL 0 until after you finish treatment unless you are unwell.

More monitoring won't hurt (other than your pocket) but is not likely to add any actionable information.

Post treatment we wait to see if you VL 0 was a real zero or if you still had some HCV below our limit of detection (which is where recurrence comes from).

• A viral load of zero at 4 weeks (SVR 4) predicts a 97% chance of being SVR24
• A viral load of zero at 12 weeks (SVR 12) predicts a 99.7% chance of being SVR24
• A viral load of zero at 4 weeks (SVR 24) predicts a 100% chance of being SVR24

SVR24 means < 1% chance of ever seeing the virus again.

No I could not prescribe it (on the PBS). I could prescribe it privately but it costs $14,000

The PBS listing is here: www.pbs.gov.au/medicine/item/10197q-10200w

It's an authority item. Click on the red "Authority Required" and you will see the requirements to qualify for it are:

Chronic genotype 1 hepatitis C infection

Clinical criteria:

Patient must have compensated liver disease,

AND

Patient must not have received prior interferon alfa or peginterferon alfa treatment for hepatitis C,

AND

The treatment must be in combination with peginterferon alfa and ribavirin,

AND

The treatment must be limited to a maximum duration of 12 weeks,

AND

The treatment must cease if the results of an HCV RNA quantitative assay at week 4 show that the plasma HCV RNA is 25 IU/mL or greater.

Population criteria:

Patient must be aged 18 years or older,

AND

Patient must not be pregnant or breastfeeding. Female partners of male patients must not be pregnant. Patients and their partners must each be using an effective form of contraception if of child-bearing age.

Treatment criteria:

Must be treated in an accredited treatment centre.

Evidence of chronic genotype 1 hepatitis C infection (repeatedly anti-HCV positive and HCV RNA positive) must be documented in the patient's medical records.

Patients who have received prior treatment with an NS3/4A protease inhibitor are not eligible to receive PBS-subsidised simeprevir, except where the patient has developed an intolerance to the other NS3/4A protease inhibitor of a severity necessitating permanent treatment withdrawal. Details of the intolerance must be documented in the patient's medical records.

Authority Required
Chronic genotype 1 hepatitis C infection

Clinical criteria:

Patient must have compensated liver disease,

AND

Patient must have received prior treatment with interferon alfa or peginterferon alfa for hepatitis C,

AND

The treatment must be in combination with peginterferon alfa and ribavirin,

AND

The treatment must be limited to a maximum duration of 12 weeks,

AND

The treatment must cease if the results of an HCV RNA quantitative assay at week 4 show that the plasma HCV RNA is 25 IU/mL or greater.

Population criteria:

Patient must be 18 years or older,

AND

Patient must not be pregnant or breastfeeding. Female partners of male patients must not be pregnant. Patients and their partners must each be using an effective form of contraception if of child-bearing age.

Treatment criteria:

Must be treated in an accredited treatment centre.

Evidence of chronic genotype 1 hepatitis C infection (repeatedly anti-HCV positive and HCV RNA positive) must be documented in the patient's medical records.

Patients who have received prior treatment with an NS3/4A protease inhibitor are not eligible to receive PBS-subsidised simeprevir, except where the patient has developed an intolerance to the other NS3/4A protease inhibitor of a severity necessitating permanent treatment withdrawal. Details of the intolerance must be documented in the patient's medical records.

So it you wanted to have Interferon and Riba as well, and you were being treated in an accredited treatment centre (read Liver Clinic) it can be prescribed.

Thanks very much, Dr. Freeman. I really appreciate the feedback. Regards, Gary

What is Cr&E?

The same procedure for Sofusbuvir+ledipasvir?