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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