Author Archives: Dr James

Detailed expert guidelines are great but often run to hundreds of pages meaning it can be hard to find the specific information you want. Giten Khwairakpam from TREAT Asia / amfAR just shared this awesome executive summary with me, so I’m sharing it here with you. As a part of TREAT Asia/ amfAR’s efforts to […]

Here is an article from the South Centre in Geneva. Abstract: In late 2013, a new Hepatitis C treatment called direct-acting antivirals (DAAs) was introduced in the market at unaffordable prices. The eradication of the disease is possible if medicines can be purchased at AFFORDABLE prices within health budgets. IF THIS IS NOT THE CASE, governments […]

AFP is short for Alpha FetoProtein. As the “feto” in the name suggests this is a protein we see in a fetus. In adults we switch off the genes that produce it so we don’t see much (usually <12 units) Hepatocellular Carcinoma (HCC) represents a loss of control over liver cell growth. These liver cells tend to […]

So today, on the chat a patient mentioned “My doctor here is scaring me from getting treated. He is tell that the treatment can be poisonous.” 5 years ago this doctor would have been correct, in fact, I used to think the same, going so far as to say “The treatment is worse than the […]

Here is a question I was asked: I am a biochemist myself and studied virology many years ago. Unlike HIV, HEP C doesn’t seem to reside in reservoirs. So looking at your SVR rates they are impressive but could you maybe give me a high level reason why treatment fails? Apart from reinfection where could […]

When the drug Harvoni was announced back in 2014, it was very welcome news for Hepatitis C sufferers around the world. Finally, a single pill treatment for this notorious disease was available. Taken once daily for just 12 weeks, it cured 95% of patients with minimal side effects. Unfortunately, the excitement lasted only until the […]

The good news is that Gilead plans to launch generic versions of Harvoni and Epclusa in the USA. The bad news is the $24,000 USD price tag. Although this price is substantially lower than list price, the reality is that the VA negotiated a $25,000 price nearly a year ago, so the payers have been […]

The stigma and stereotype associated with Hepatitis C says “you only get that from IV drug use”. While you certainly can get it from IV drug use, the majority of my Baby Boomer patients didn’t. How do I know? Well, of course, I can’t know for sure how anybody caught any communicable disease, but when […]

For patients with Hepatocellular Carcinoma (HCC) the options are limited. Caught early enough RadioFrequency Ablation (RFC), TransArterial ChemoEmbolisation (TACE) or surgical resection can potentially be curative. For some patients with advanced disease a liver transplant may be an option, but what about everyone else? Up until recently, Sorafanib was the mainstay of treatment and the only […]