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

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