TOPIC:

My fasting glucose level has shot up to 11.9

You should be on some metformin to bring that down.

Great news Hope. I am now cured and I took Chinese Sof/Led!!! Luckily I had a very good GP who was incredibly supportive. Keep on keeping on

Hi Hope.

If you do exercise as well as low GI eating, it may help your sugar levels.
I was IR before my last tx and got stuck into healthy low GI diet & exercise, that did the trick for me, but please listen to Dr J as he's a doctor!!

It seems the virus does something to us that can make people IR ( Insulin Resistant) pre diabetic.
xo

I only wish I would know that half a year ago...but anyway I was well aware that this are new drugs and we are experimenting a bit.

Dr.Freeman, do you know wich research wich is not published yet is Greg talking about?

www.hepmag.com/blog/hepatitis-genotype-3-sofosbuvir-daclatasvir

Hi Hope

Thanks for your speedy reply.

Firstly, congratulations on being Week 8 UND! It makes me sad reading the crap you have had to put up with …

On a separate issue, it sounds like we are peas in a pod … my ferritin levels are high too, just under the upper range limit, but I’m not too worried about it b/c it’s always been high … par for the course if you have HCV I think … plus I grow & eat a lot of my own leafy green vegies (silver beat, bok choy, kale etc … got some broccolini growing at the moment too ) .

The 11.9 fasting glucose is worrying to me … I think that I’ll get some blood tests done at week 8 and see if it has come down like it did for you. If not, I’ll follow Dr Freeman’s advice and see if I can get a prescription for metformin.

Thanks for your quick response and professional advice Dr Freeman, I appreciate it.

Thanks CJ for sharing your low GI diet and exercise story.

P.S.
I’ve got my week 4 viral load test result back today … HCV RNA is Not Detected. Pretty cool hey!

fixhepc.com/forum/gt2/994-gt2-honks-his-....html?start=30#16346

Dr.Freeman, do you know wich research wich is not published yet is Greg talking about?

Yes, his, mine and other people we know.

SOF+DCV in GT1 is getting really good SVR rates of 95%+ but the same SOF+DCV in GT3 is seeing SVR rates below 90% in the 12 week patients. Looking at the kinetics we see that in GT1 SOF+DCV is as good or better than SOF+LDV, but when we compare SOF+DCV in GT1 and GT3:




Now my interpretation of this graph is that while in GT1 we are reliably at UND by about 55 days (giving a 30 day over-treat) this is not the case in GT3 which decays much slower. This slower decay suggests longer treatment is required if we want the same insurance over-treatment buffer we have in GT1.

The sad reality is that the current DAA agents are worst in GT3, and Ribavirin does not seem to help much (if at all), so in the absence of better what we have for the moment is LONGER (or adding in Interferon and Riba)

I know people don't like to hear it but for some low fibrosis/low life impact GT3 patients waiting for better agents is a perfectly sane option, as is treating for a bit longer than current guidelines suggest for F0-F2

So the hardest to treat strain is now GT3?

So the hardest to treat strain is now GT3?

Yes, without any doubt. Although the DAAs are better than PEG/Riba across the board, PEG/Riba used to do best in GT3 and is still an option for salvage with Sofosbuvir.

Ok, do we know approx. how manny % of GT3 reach SVR with Sof/Dac? At least in the population you're monitoring?
I see you've written below 90 %. How much below

Will cirrhosis a few percent below 90%, without a few percent above 90%. Exactly as expected from prior trials.

Past failure and cirrhosis remain small negative predictors of success.

The past failure is probably just a surrogate marker for IL28 TT or CT or other patient based immune issues.

I know this is out there Doc but is there a therapeutic dose that could be considered for G3's who relapse just to keep the virus in check once it's cleared ?

cheers

Hi Hope
I'm really backing you I want you to get SVR12
I'm glad to read so much loving kindness for your anxiety here you know I think of you and send you a hug as you go toward this important blood test.
We must be about the same EOT timing my SVR12 hospital appointment to follow up bloods is 1 July so I need to get them taken a good week prior to that
I'm just happy to see how much love and support you have its brought tears to my eyes
Anxiety is tough Hope
I'm one friend who won't ever underrate the effect of it or judge anyone who suffers anxiety
After all, my own father did four active tours of duty in WW2 as a wireless airgunner and he was my best mate and overcame intense anxiety from the War.
Sending you love and fingers crossed for your SVR12 From Ariel who totally understands anxious symptoms (peginf legacy in my case as you know but I'm a bit frightened to talk about my terrible issue here these days) I can only say
I UNDERSTAND
Love from Ariel

I know this is out there Doc but is there a therapeutic dose that could be considered for G3's who relapse just to keep the virus in check once it's cleared ?

In the dose scoping trials (with PEG+Riba) the 200 mg dose of Sof saw only 94% UND at EOT, but with 400 mg it was 100%. SVR rates were 90% and 91%.

www.ncbi.nlm.nih.gov/pmc/articles/PMC396...e1-1756283X13515825/

Conclusion: We see virological breakthrough in 6% of patients on low (200 mg) dose Sof so 400 mg daily is where it needs to be.