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)
Prothrombin Time - A measure of how many seconds it takes the blood to coagulate - See INR
Resistance Associated Variant aka drug resistant mutants
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
API
Active Pharmaceutical Ingredient
Ascites
Fluid collecting in abdomen and typically due to liver failure and low albumin
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
Cirrhosis
Extensive fibrosis of the liver often leading to liver failure and or HepatoCellular Carcinoma
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
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
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
Fibroscan
A special type of ultrasound to assess fibrosis - 13 kPa marks the non cirrhosis / cirrhosis point
Filler
An inactive substance added to and API to make filling capsules (by volume) easier. Cellulose and lactose are commonly used.
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.”
GP
General Practitioner - the medical version of a Leatherman tool
Greed
See above
Haemoglobin
A protein that is present in red blood cells and can carry up to 2 oxygen molecules
Half Life
The time taken for a medication to fall to 1/2 the originally measured level
Hb
Haemoglobin
HCC
HepatoCellular Carcinoma - liver cancer, usually due to cirrhosis
Hct
Heamatocrit - a measure of red cells in blood
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
LMF
Lack of Moral Fibre - originally used in WW1 but possibly applicable to Governments at large
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)
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
Mutant
A variant form of HCV created by the process of genetic mutation
Mutatation
Changes to the genetic code of an organism, for HCV mutations that provision resistance are a worry
Neutropaenia
Low white cells in blood (Neutrophils)
NHS
National Health Service (or alternatively = Not Happening Soon)
NICE
National Institute for health and Care Excellence
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 of
PCR
Polymerase Chain Reaction - A technique to amplify DNA/RNA to levels that can be measured
PEG
Pegulated Interferon
Phamacokinetics
The behaviour of chemicals that do nifty things to people when injected or ingested including things like AUC, Cmax, t 1/2
Pharmacology
The study of chemicals that do nifty things to people
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)
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
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
SVR4
SVR 4 weeks post finishing treatment - 96% 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.
WCC
White Cell Count
White Cell
One of several types of infection fighting cell in the body - Neutrophils, Lymphocytes, Monocytes, Eosinophils and Basophils are all white cells

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