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- This topic has 18 replies, 10 voices, and was last updated 7 years, 4 months ago by Gaj.
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12 November 2015 at 3:25 am #3703
Dear FixHepC team,
This site has a wealth of medical information and I’ve learned loads about Hep C.
But some of the medical lingo can be confusing.
How about a glossary section to explain all the abbreviations and initialisms? DAAs, APIs, PPIs, Tx, Dx, SVR, etc etc
Thank you for the wonderful work you are doing.
12 November 2015 at 3:42 am #3704Really good idea, Joy
Seconded!
GT1a since 1988, diagnosed 1990
F0, tx naive
VL 262,000 ALT 40 AST 26 GGT 13 Fibroscan 04/12/15 – 2.9
Started Mesochem sof/dac 12 weeks 01/01/2016
11/02/2016 – 6 weeks UNDETECTED
AST 26
ALT 2612 November 2015 at 2:04 pm #3739Check out the new tab on the Forum.
Please add suggestions to this thread.
YMMV
12 November 2015 at 2:11 pm #3741Wow that was quick work…
Cracked up at ‘Compassionate Access’
Thank you!
12 November 2015 at 6:46 pm #3756That was a cracker lol
Great work, thanks Dr!
Could I suggest ‘warehoused’ – The practice of keeping patients in treatment-mothballs while promising more effective drugs will be in the pipeline on a perpetual timeline of “soon”
GT1a since 1988, diagnosed 1990
F0, tx naive
VL 262,000 ALT 40 AST 26 GGT 13 Fibroscan 04/12/15 – 2.9
Started Mesochem sof/dac 12 weeks 01/01/2016
11/02/2016 – 6 weeks UNDETECTED
AST 26
ALT 2612 November 2015 at 7:06 pm #3757The meaning of local abbreviations would be useful.
In the UK:
NHS = National Health Service (or alternatively = Not Happening Soon)
GP = General Practitioner
NICE = National Institute for health and Care ExcellenceAnd:
EASL = European Association for the Study of the Liver
Also, this one’s good for a chortle:
4 December 2015 at 3:32 am #5216Patient = human being in need of treatment, who often has to wait for a long time. See “warehouse”.
Diagnosed Jan 2015: GT3, A0+F0/F1. Fatigue + Brain-Fog.
Started Sof+Dac from fixHepC 10-Nov-2015. NO sides.
Pre-Tx: AST 82, ALT 133, Viral Load 1 900 000.
Week4: AST 47, ALT 58. VL < 15 (unquantifiable). Week12 (EOT): AST 30, ALT 26, VL UND Week16 (EOT+4): AST 32, ALT 28, GGT 24, VL UND Week28 (EOT+16): AST 26, ALT 22, GGT 24, VL UND Ever grateful to Dr James. Relapsed somewhere after all that... Bummer! Jan 2018: VL 63 000 (still GT3).25 December 2015 at 2:56 pm #7280Suggestions
Doctor code for times – 4/52, 8/52 etc
Abbreviations for drug names – SOF, DAC, LED etc. not sure if these are the normal “doctor” abbreviations.
M 61yo HCV+ ~ 30 yrs Gt1a F2 VL 223,000 ALT 54 AST 42 Tx start Sof/Dac 17Dec15.
SVR4 at 7Apr16 ALT 22 AST 22
SVR12 at 9Jun16 ALT 23 AST 25
Melbourne, Australia30 December 2015 at 9:12 am #7518Treatment naive?
how long into interferon and riba treatment is required to be not naive? I seem to remember they found out quickly interferon (alone) was not working for me.
how long ago would this be relevant?
the estimator programs that have been placed on this site usually seem to ask this, but my experience with interferon then interferon with riba was 15 odd years ago (and momentary at that).
fiddling with the latest program placed here (and thanks for that!) it seems to make little difference?? and the F score seems the most important, particularly from F3 to F4?
yours
J.
P.S. not sure this is all glossary stuff
30 December 2015 at 11:10 am #7527Interferon alone is classified as treatment naive by the guidelines.
Interferon+Ribavirin is treatment experienced.
Failure with protease inhibitors is a special case that doubles treatment duration.
YMMV
30 December 2015 at 3:57 pm #7560“Failure with protease inhibitors is a special case that doubles treatment duration. ”
I have been inclined to agree with this all along but this is the first time I have actually heard a doctor say it. Any links that you can post on the subject would be much appreciated.
The Gilead Harvoni studies did not find that previous failure with a protease inhibitor made a difference to the 12 week duration of Harvoni tx. I do have previous failure with a protease inhibitor (telaprevir) and I have been suspicious that people are being palmed off with the 12 week duration because of the price of 24 weeks. I wonder if this has been done by Gilead in order not to lose the market of people who are protease inhibitor experienced.
Just because I’m paranoid does not mean they are not out to get me.
dt
30 December 2015 at 5:18 pm #7568KP
dointime wrote:Just because I’m paranoid does not mean they are not out to get me.
dt
Uh, no. I was just spotting birds through the telescopic sights……..honest!
But now I understand your questions about longer treatment in the other threads. More details may help us to help you but in this case it sounds like you need expert advice.
G3a since ’78 – Dx ’12 – F4 (2xHCC)
24wk Tx – PEG/Riba/Dac 2013 relapsed
24wk Tx – Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx – 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 – 22/06/17 UND
SRV12 – 27/07/17 UND
SVR24 – 26/10/17 UND
31 December 2015 at 2:43 am #7595I have been inclined to agree with this all along but this is the first time I have actually heard a doctor say it. Any links that you can post on the subject would be much appreciated.
If you have a look at:
http://fixhepc.com/blog/item/34-pbs-listing-some-tears-in-heaven.html
You will find the draft Australian protocols for treatment where past failure with protease inhibitors is specifically treated as a special case in extending Sof+Dac from 12 -> 24 weeks
http://fixhepc.com/images/misc/HCV-DAA-Protocols.pdf
If you use the tool at http://fixhepc.com/decision-support
And select GT1, F0, Failed Protease+Interferon+Riba
Then the Sof+Dac suggestion will come up as 24 weeks in line with the “24 weeks recommended for patients who have failed a protease inhibitor” note in the guidelines.
YMMV
31 December 2015 at 3:02 pm #7646I have now had a good look at these links and if I am understanding them correctly then I think I need to set the record straight.
The decision support tool shows, for a person genotype 1b, F0-F1, failed protease inhibitor+ifn+riba, that led+sof for 12 weeks = 98% SVR. It does not recommend 24 weeks for the led+sof combo. This is consistent with the Gilead trials for people who are tx experienced with a protease inhibitor.
*** In other words, my suspicions that Gilead fudged the duration of the led+sof combo have been unfounded, according to these recommendations. ***
For the dac+sof combo it is another matter. dac+sof does get a duration of 24 weeks with a 90% SVR outcome, obviously inferior to the led+sof combo for this cohort of people (protease experienced).
So that is a somewhat surprising find for me but hey, who am I to argue with it. Obviously somebody somewhere has formulated these recommendations for a reason. It would be interesting to know those reasons. One presumes that there were trials done on the dac+sof combo. The only trials I know about were the phase 2 trials done before Gilead rejected the BMS dac and decided to go with their own NS5A, ie. led. True enough, I believe that those trials were done for 24 weeks. The progress of dac has always been hindered by the lack of trial data after the split with BMS (except for geno3).
Anyway I am happy to get some clarity on this.
dt31 December 2015 at 5:32 pm #7648GAJ – I hear your advice about getting expert help but don’t worry. My long-suffering doc is in fact an expert of long standing experience.
I am just not the type to swallow any advice whole. I have to do my own due diligence. Well, I figure that at the end of the day it is MY body and MY life at risk so I better understand what is going on.
dt -
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