TOPIC: Any ideas on how the treatment goes?

Hi
I want to start with a THANK YOU addressed to the fixhepc team for the wonderful job they are doing.

Is there any one who can help me with the interpretation of how the treatment goes?

Patient 58 Years old Female
Gen 1 hepatitis C with Cirrhosis ; Fibroscan 31.6 kPa, F4 Fibrosis

Treatment : LEDIHIP sofosbuvir 400+ledipasvir 90



After 4 weeks of treatment The Lab Analysis came :
Virology :
Hep C viral load (Abbott) - DETECTED < 12 IU/ml
Hep C viral load (LOG) - <1.08

Blood test :
Haematology
White blood cells Result 2.95 x 10^9/L flag (LOW) reference range 3.50-11.0
Platelets Result 60 x 10^9/L flag (LOW) reference range 150-400
Neutrophils Result 1.57 x 10^9 /L flag (LOW) reference range 2.0-8.0
Biochemistry
Transferrin Result 3.66 g //L flag (high) reference range 1.93-3.08
Globulin Result 41 g/L flag (high) reference range 26-39
HDL cholesterol Result 1.47mmol/L flag (LOW) reference range >1.55
HDL Cholesterol Result 3.4 mmol/l flag (high) reference range <2.6

All the rest are in normal range.

First moth she felt great, Extra Energy and

Now The patient feels fatigue, light nausea and light head aches ( Hang Over like feeling). Fells body heat witch grows and diminishes,
and encounters blood pressure spikes (150-80; 140- 80; 124-72; 120- 74 ; 120-68 ; 106-60 different day measurements) .
She drinks 1.5 L of water a day the most and eats healthy food. Medium exercises.

So what i am looking for is knowing how the treatment goes and how many more weeks we should keep taking the medicine.

Thank You !
I hope Dr James Freeman see this post to.

Hello,

This patient has high fibrosis and definite cirrhosis so would benefit from more than 12 weeks treatment - 24 is ideal. If treatment length is 12 weeks then using Ribavirin should be viewed as important.

4 week result is ok. Undetected would be better but <12 is undetected for test that does <25

Low platelets are expected. Other results are within expectations.

We do see some degree of fatigue in some patients on treatment. Vitamin B12 and Vitamin D seem to have helped some people.

Blood pressure is nothing to worry about.

Water, food, and exercise sound fine.

Thank you for your response Doc!
Now the Ribavirin or another 12 weeks of treatment will not affect the cirrhotic leaver? In other words should the patient worry about any worsening of cirrhosis if she chose to take an extended treatment?

The need for extended treatment is to increase the success rate.

The cirrhosis will continue to get worse if the disease is not cured.

Hi
Those are the last 4 weeks of the 12 week treatment and we are unable to get a second 12 week treatment on time...

Could we start using Ribavirin now or is too late to start it in the last 4 weeks of the treatment?

Thank you for your previous responses Dr Freeman !

Yes, adding Ribavirin now could be of use.

With 4 weeks to go it is possible to get medication to you within that time.