To add to Alsdad’s point here is part of an email conversation with a widely respected Specialist

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Re GT3, my recommendation is 12 weeks SOF/DCV for F0-3 and 24 weeks for F4. I also do not like RBV. It may help in patients with decompensated cirrhosis, but they are the patients least able to tolerate it. It may enable shortening of therapy so 16 weeks SOF/DCV/RBV probably equivalent to 24 weeks SOF/DCV for GT3 F4, but given how well tolerated, I would prefer latter regimen.

Again, with GT1 F4 (treatment experienced) can use SOF/LDV 24 weeks or +RBV 12 weeks. But, particularly with PBS listing being up to 24 weeks for this group (same for SOF/DCV in GT3 F4) I will probably recommend 24 weeks without RBV.

A simple decision support tool would be a great idea. There will be Australian HCV consensus treatment guidelines released early next year, but these will be quite detailed, wordy etc.

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We are just double checking the output of the Decision Support Tool now.

IF I simply went by the US official FDA guidelines, and what my very specially trained, Gastroenterologist knew, I would presently be suffering under the horrible side effects of Ribavirin right now! A Gastroenterologist, and she’s at a well respected clinic, and she’s not dumb, STILL didn’t know as much as Dr. Freeman on this subject with the generic meds and treating without Ribavirin.

Instead, I knew from my own research which was thankfully confirmed by Dr. Freeman, that I didn’t need Ribavirin, all I needed was Sofosbuvir and Daclatasvir, which I’m now 7 weeks into, and undetected and NO side effects.

A year from now I’ll bet no one will be prescribing Ribavirin anymore–Even our backwards US FDA is only saying its for GT 2 anymore, and I’ve read that’s only because there are so few of us that no one has put in the effort to do testing of the new DAA’s on the GT2’s because there aren’t enough of us to make for a “profitable” market supply.

U

Hi Nonna,

As one of those people, I totally agree with the quoted statement. That was exactly my approach, go and see my specialist and discuss my treatment with him, get his recommendation of the most appropriate treatment, then cross the bridge of whether he would prescribe it for me (he did) or whether I needed to get the script he recommended elsewhere.
As your friend apparently has a supportive specialist, I’m trying to understand why she felt a need to get advice via a forum instead of a medical consultation, presumably used that to ask for (and was given) an inappropriate script from her GP, then ordered the DAAs and only after that told the specialist?

Anyway, hopefully you friend is now on the correct treatment as advised by her specialist and on her way to SVR.