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TOPIC: Need some help

Need some help 3 years 8 months ago #11275

I have no doctor to supervise the treatment, so I am looking for some help in this group.

I am HCV Genotype 1A. Treatment naive. VL 1.3 million IU/ml. CT scans and Echo scans don't show any cirrhosis.

Will start on Monday the 22nd with My HEP-LVIR from Mylan. (Sofosbuvir 400mg + Ledipasvir 90mg)

Intent to do 12 weeks even though:

"HARVONI for 8 weeks can be considered in treatment-naïve genotype 1 patients without cirrhosis who have pre-treatment HCV RNA less than 6 million IU/mL"

Should I do a blood test before, during or after the treatment?

Should I take the meds before or after meals?

I eat loads of fruit every day, will that affect treatment?
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Need some help 3 years 8 months ago #11277

  • Chester
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Rene Martin wrote:
I have no doctor to supervise the treatment, so I am looking for some help in this group.

I am HCV Genotype 1A. Treatment naive. VL 1.3 million IU/ml. CT scans and Echo scans don't show any cirrhosis.

Will start on Monday the 22nd with My HEP-LVIR from Mylan. (Sofosbuvir 400mg + Ledipasvir 90mg)

Intent to do 12 weeks even though:

"HARVONI for 8 weeks can be considered in treatment-naïve genotype 1 patients without cirrhosis who have pre-treatment HCV RNA less than 6 million IU/mL"

Should I do a blood test before, during or after the treatment?

Should I take the meds before or after meals?

I eat loads of fruit every day, will that affect treatment?

Hi Rene and welcome,

As far as supervision goes, it would help to know what country you are in.

If those test results are recent you don't need any others before starting treatment.

You can take the meds whenever you want. AFAIK any theories about the best time to take meds are just that, theories. As some people experience insomnia it may be better to take them in the morning so the levels are lower by the time you go to bed.

Certain fruits are out - grapefruit, Seville oranges, paw paw, star fruit, pomegranate. See here. Also certain supplements.

If you eat a lot of any one thing or take supplements it's maybe a good idea to check for interactions. Drug interactions can be found here. With foods and supplements it may be worth googling the item and CYP3A4 or asking. Personally, I don't take supplements but my approach in general was to just eat a well balanced diet with all things (excluding the known problem foods of course) in moderation. These drugs are so new, there may well be interactions that are as yet unknown.

Good to hear you've got the cure and are ready to start. The very best of luck.

Bet you're glad your folks didn't call you Rémy. :lol:
Huon Valley, Tasmania
Hep C+ since 1980s
Genotype 1b
F3/4
VL 480,000
Started Indian Sof and Riba, BMS Dac (comp access) 28 August 2015
UND at 4 weeks
Finished treatment 19 November 2015
12 February 2016 UND SVR12
Last Edit: 3 years 4 months ago by Hieupham.
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Need some help 3 years 8 months ago #11317

  • Geno1b4
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Hi Rene,
My choice was to do the full 12 weeks tx just to be sure. No need to save few hundred bucks and increase risk of relapse.
As for interactions the ones Chester mentions are for Sofosbuvir/Daclatasvir regarding Daclatasvir interactions.
We should not eat Grapefruit and st.Johns worth, but I also stopped using all supplements and vitamins including milk thistle just to be on the safe side.
Genotype 1b & 4, F0/A1, failed Peg&Riba TX 2015,
22 Jan. 2016 - Back from Delhi with 12 week Ledifos supply :) Thx to Parag
Started TX on 27.Jan.2016 - AST 41, ALT 59, GGT 39, ALP 74, VL 500.000, Fibroscan 6.8
19. Feb 2016 - ALT 14, AST 14, GGT 19, ALP 107
19. Apr 2016 EOT - Undetected :)
26. Apr 2016 (1 week after EOT) - ALT 14, AST 17, GGT 12, ALP 77
28. Aug 2016 (17 weeks after EOT) - UND, ALT 15, AST 12, GGT 5, ALP 39 :)
Last Edit: 3 years 8 months ago by Geno1b4.
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The following user(s) said Thank You: james85

Need some help 3 years 8 months ago #11326

  • DrJames
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I have no doctor to supervise the treatment, so I am looking for some help in this group.

We can do it online but what we do, when and why is listed on our doctor's cheat sheet

It would be perfectly reasonable to just take the meds and do an SVR4/12. The suspense might well kill you, but the blood tests don't impact on SVR.
Should I do a blood test before, during or after the treatment?

You appear to have enough baseline data (assuming you have a liver panel)

A rapid fall in ALT happens over the first week(s) and is quick and cheap.
Should I take the meds before or after meals?

Either is fine. With or without food, morning or night
I eat loads of fruit every day, will that affect treatment?

Almost certainly not, but if you are heading on for being a "fruitarian" you may well be deficient in some essential nutrients. A varied diet on treatment means if a particular food is causing an issue at least you're not eating it tomorrow!
YMMV
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Need some help 3 years 8 months ago #11340

  • mgalbrai
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Rene,
There you go! House calls may have gone out with the milkman, but our esteemed Dr. James brings back a 21st century version of that old practice.
Plus, you can't beat the price!
Nobody, no where knows no more about generic HCV tx and DAAs than him.
If somebody wants to argue that that point, especially if they're from the Lone Star state, I will be happy to oblige.
Now, follow the "doctor's orders" and put "ex HCV sufferer" in your resume!
Good Luck!
Mike

ps-are you in the U.S.?
This email address is being protected from spambots. You need JavaScript enabled to view it.
forums.delphiforums.com/generichcvtx

G 1a F-1
Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil
11/17/15 4 wk lab ALT 17 AST 16 <15
11/18/15 Started Harvoni
12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND
1/14/16 Fin. Tx
7/07/16 UND SVR 24
Last Edit: 3 years 8 months ago by mgalbrai.
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The following user(s) said Thank You: dointime

Need some help 3 years 8 months ago #11342

  • dointime
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Mike,
I just want to say a one time big Thank You for all your entertaining posts which somehow manage to introduce a ray of sunshine into some dark posts and make me smile. I am also fascinated by your caricatures on various quirks of American culture. Hilarious.
dt
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Need some help 3 years 8 months ago #11424

  • Price
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I tend to be overly cautious. I don't think it's a good idea to treat without the supervision of a doctor who can review your history and the meds you take and be there if you develop any problems.

P
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