Glossary

2/52 4/52 6/52 8/52 - Doctor shorthand for 2 weeks, 4 weeks, 6 weeks and 8 weeks respectively (52 weeks in a year - get it?)

5/7 - Doctor shorthand for 5 days (out of a 7 day week)

AASLD - American Association for the Study of Liver Disease - Like EASL issues treatment guidelines

Albumin - A protein produced by the liver and present in blood

Anaemia - Low red cells in the blood

Ascites - Fluid collecting in abdomen and typically due to liver failure and low albumin

API - Active Pharmaceutical Ingredient

AUC - Area Under the Curve - A pharmacokinetic parameter that looks at the concentration of a medicine in the blood over time

Biopsy - Being speared through the liver by a radiologist with a large needle and then charged for the privilege - used to determine liver cirrhosis and definitive

Blood - Red stuff - A mixture of water, salt, proteins like albumin, red cells, white cells, and platelets

Cell - A single unit of life that unlike a virus can typically make copies of itself without help

Clotting Time - The number of seconds it takes blood to coagulate - Only used in primitive settings where INR can not be measured

Cmax - The maximum concentration of a medicine in the blood following administration

Coagulation - The process of liquid blood turning to jelly to help stop bleeding

Coagulation Factor - A number of proteins produced by the liver and present in the blood - They function in a cascade of reactions that stops bleeding

Cirrhosis - Extensive fibrosis of the liver often leading to liver failure and or HepatoCellular Carcinoma

Compassionate Access - A PR stunt giving nearly dead patients free treatment (often too late to make a difference) possibly on the basis they were not going to be paying customers either way

Compounding - The process of making a powder API into a convenient tablet or capsule

Consultant - A specialist doctor like a gastroenterologist

Creatinine - A chemical in the body that comes from muscle and is excreted by the kidneys so the levels are low when the kidneys are working well, and higher in renal failure - Low is good, high is bad

CT - Computed Tomography - A special type of Xray machine that slices through you and can look at the liver, kidneys and all your other internal parts

CYP3A4 - A liver enzyme that breaks down Daclatasvir

DAA - Direct Acting Antiviral Medication - Sofosbuvir, Ledipasvir, Daclatasvir, Simeprevir, Ribavirin

Dac - Daclatasvir

Daclatasvir - A DDA that inhibits NS5A

DNA - DeoxyRiboNucleic Acid - the genetic code for people using the letters C G A T

Dx - Diagnosis

EASL - European Association for the Study of the Liver - Issue trusted HCV treatment guidelines

eGRF - estimated Glomerular Filtration Rate - a measure of kidney function >60 is good, <60 is bad, <30 is really bad, <15 is really really bad

Excipient - An inactive part of a tablet - Excipients help stabilise the API in a tablet, help the tablet hold together, and also help it fall apart in your body

Filler - An inactive substance added to and API to make filling capsules (by volume) easier. Cellulose and lactose are commonly used.

Fibroscan - A special type of ultrasound to assess fibrosis - 13 kPa marks the non cirrhosis / cirrhosis point

F Score - A measure of liver fibrosis. F0 is good. F4 is cirrhosis.

F0 - Good

F1-F3 - Increasingly F'd

F4 - Bad - Indicates cirrhosis is likely to be present

Gilead - The Pharmaceutical company that purchased the Sofosbuvir patent from Pharmasset and charge very high prices

Gordon Gecko - A fictional character from the Movie Wall Street famed for his catchphrase “Greed, for lack of a better word, is good. Greed is right. Greed works. Greed clarifies and cuts through to the essence of the evolutionary spirit.”

Greed - See above

GP - General Practitioner - the medical version of a Leatherman tool

Half Life - The time taken for a medication to fall to 1/2 the originally measured level

Haemoglobin - A protein that is present in red blood cells and can carry up to 2 oxygen molecules

Hb - Haemoglobin

Hct - Heamatocrit - a measure of red cells in blood

HCC - HepatoCellular Carcinoma - liver cancer, usually due to cirrhosis

HCV - Hepatitis C Virus

Hepascore - An estimate of liver fibrosis based on blood results

HPLC - High Performace Liquid Chromatography

Inactive - Some chemical or substance that is not an API

Inert - see Inactive

INR - International Normalised Ratio - A measure of how well the blood coagulates - Normally 0.9-1.1 and elevated in liver failure - Calculated from Prothrombin Time (PT) to correct for test differences

Led - Ledipasvir

Ledipasvir - A DAA that inhibits NS5A

Log - 1000 = 10*10*10 = 10^3 = log 3 - a convenient way to talk about viral load so 1,000,000 is log 6 (count the zeros) and 100,000 is log 5 etc

Log Drop - For each 1 unit log drop the viral load has fallen by a factor of 10 ie 1,000,000 to 1000 would be a 3 log drop (10^6 to 10^3)

LMF - Lack of Moral Fibre - originally used in WW1 but possibly applicable to Governments at large

Mass Spectroscopy - A chemical analysis technique that can find extremely accurate molecular weights to help identify molecules

MELD - Model of End-Stage Liver Disease, a predictor of 3 month mortality often used to determine compassionate access

MRI - A big machine that goes ping, crash bang wallop and can image the liver - a bit like CT or Ultrasound

Mutatation - Changes to the genetic code of an organism, for HCV mutations that provision resistance are a worry

Mutant - A variant form of HCV created by the process of genetic mutation

Neutropaenia - Low white cells in blood (Neutrophils)

NICE - National Institute for health and Care Excellence

NHS - National Health Service (or alternatively = Not Happening Soon)

NMR - Nuclear Magnetic Resonance - a way to check an organic molecules structure

Non A Non B - What doctors called HCV before it was identified in 1988

NS3/4 - A controller protein in HCV inhibited by Simeprevir

NS5A - A controller protein in HCV inhibited by Ledipasvir and Daclatasvir

NS5B - The RNA polymerase in HCV inhibited by Sofosbuvir

Pancytopaenia - Low red cells, white cells and platelets in the blood

Patient - Human being in need of treatment, who often has to wait for a long time. See "Warehoused"

PCR - Polymerase Chain Reaction - A technique to amplify DNA/RNA to levels that can be measured

PEG - Pegulated Interferon

Pharmacology - The study of chemicals that do nifty things to people

Phamacokinetics - The behaviour of chemicals that do nifty things to people when injected or ingested including things like AUC, Cmax, t 1/2

Platelet - A small cell fragment in the blood that helps stop bleeding - normal range 150-450

Portal Hypertension - A pressure increase in the portal vein typically caused by cirrhosis and that leads to varices

PPI - Proton Pump Inhibitor (Anti-acid medications)

PT - Prothrombin Time - A measure of how many seconds it takes the blood to coagulate - See INR

RAV - Resistance Associated Variant aka drug resistant mutants

Red Cell - The cells in the blood that carry oxygen

Relapse - Stopping treatment and having the virus reappear - the opposite of SVR

Riba - Ribavirin

RNA - RiboNucleic Acic - the genetic code for HCV using the letters C G A U

RNA Polymerase - The HCV protein that acts as the photocopier to make more HCV RNA

RVR - Rapid Virological Response - a large fall in viral load in a short time

Scrap Heap - The purgatory you must pass through to get from warehoused to compassionate access

Sides - Unwanted effects of taking medication

Sof - Sofosbuvir

Sofosbuvir - A DAA that inhibits NS5B

SVR - Sustained Virological Response (ie undetectable viral RNA) measured in weeks since stopping treatment

SVR4 - SVR 4 weeks post finishing treatment - 96% probability of being permanently cured

SVR12 - SVR 12 weeks post finishing treatment - 99% probability of being permanently cured

SVR24 - SVR 24 weeks post finishing treatment > 99.5% probability of being permanently cured

t 1/2 - Time 1/2 (see Half Life)

Thrombocytopenia - Low platelets in blood - normally 150-450, less than 50 is bad, less then 10 is extremely bad

Tx - Transplant or Treatment

Ultrasound - A type of imaging (like CT or MRI) that can look at the liver (usually for HCC)

Variant - See mutant

Varices - Enlarged veins where the oesophagus (food pipe) joins the stomach and cause by portal hypertension. Like piles/haemorrhoids around you anus. 

Virion - A single virus

Virus - The simplest self replicating unit of genetic code - typically some container proteins, a few helper proteins, and a single bit of RNA or DNA. Incapable of replication without help from a complete cell from which it in effect hijacks the full genetic machinery to make more mini-me copies of itself, often killing the host cell in the process.

VL - Viral Load typically 100,000 to 10,000,000

Warehoused - Refers to Government's taking a view that non dying HCV patients can stay sick until DAA prices fall out of an alternate universe and make down into the pricing stratosphere.

White Cell - One of several types of infection fighting cell in the body - Neutrophils, Lymphocytes, Monocytes, Eosinophils and Basophils are all white cells

WCC - White Cell Count

Request additions here: http://fixhepc.com/forum/experts-corner/306-glossary.html