Help with my Analysis

This topic has 14 replies, 5 voices, and was last updated 8 years, 11 months ago by Dr James.

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20 November 2015 at 10:59 pm #4287
Ahmedova-Dilrabo-dilrabohon1888-twitter
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@ahmedova-dilrabo-dilrabohon1888-twitter
Hello doctor J. Freeman , I’m from the distant Tajikistan wanted to ask about my analysis, can you comment on and prescribe me drugs that inhibit the hepatitis C virus , I was just confused in their analyses and recommendations of our doctors . Here are my tests using IgG+ , IgM+, Core+, Ns3+, Ns4+ Ns5 – Ns5 which means – and I was first offered a course of treatment with Daclatasvir and Sofosbuvir however, after these analyses and Asunaprevirum assigned Sofosbuvir and peg-intron + Sofosbuvir+ Ribavirin I hope only for your answer I do not know what to do I already bought medicines of Daclatasvir and sofosbuvir . Advance very grateful , although I’m from far away but thankful to your forum . and separately you Doctor.
21 November 2015 at 1:23 am #4302
klhilde
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@klhilde
Hi,

YOU DO NOT WANT INTERFERON.

Can you give specific numbers from your tests? Dr. Freeman will need these to answer your questions.

The critical ones needed to determine treatment are your Genotype and condition of your liver from either a fibroscan or biopsy.

Also helpful are any blood levels that are outside their normal range and information about other meds you’re currently taking or medical conditions such as heart problems.

Here is information to show your doctors.
http://fixhepc.com/kunena-2015-11-10/gp-cheat-sheet.html

Sofosbuvir/Daclatisvir combo is working well across all genotypes, but depending on the condition of your liver you may either need to extend treatment from 12 weeks to 24 weeks and/or add ribavirin to the mix.

If you already have the Sof and Dac you’re almost there!
21 November 2015 at 2:10 am #4310
Dr James
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@fixhepc
As Kevin said the key things a doctor needs to know are:
- Genotype
- Fibrosis level – cirrhosis or not?
- Medications currently being taken
- Past treatment
The recommendations are here: http://fixhepc.com/getting-treated/genotype-specific-hepc-treaments.html

For most people 12 weeks Sof+Dac is fine.

With cirrhosis 24 weeks and consider adding Ribavirin

With GT 3 consider adding Ribavirin

Interferon is not really recommended anymore.

YMMV
21 November 2015 at 7:11 am #4335
Ahmedova-Dilrabo-dilrabohon1888-twitter
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@ahmedova-dilrabo-dilrabohon1888-twitter
Thank you very much Klhilde and Doc Freeman yeah sorry I wrote You the complete picture of my illness, I have Genotype 1b In naïve, never treated me according to the analysis of no in Tajikistan fibrosis fibroscan or biopsy and tests the doctor is not appointed , the clinical analysis of blood hemoglobin to -126.6, 258,6- platelets leukocytes- 6,2 GGT- in 11.05, 11- AST , ALT-33,1 Total bilirubin 10,2 just a little albumin-31,6,creatinine-76,6, alkaline phosphatase – 171,4 coagulation normal . I am 30 years old and a huge thank you for the information and I showed a recommendation for the treatment of hepatitis to the doctor and he supported you and offered to start treatment.
21 November 2015 at 7:45 am #4339
emilio
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@emilio
Amed, could I please offer my thought on testing/geno type etc. I am not a doctor but believe I’m ‘well’ read enough to provide some input.

Your genotype 1b will do really good on sofosbuvir and daclatasvir, for either 12 or 24 weeks. Please don’t consider IFN/Riba in combo. The Direct Acting Anti-Virals is what you need. Now I said 12 or 24 weeks and this will depend on your fibrosis score. If it happens to be F0-F2, 12 weeks will be sufficient, however if 3-4 cirrhosis you will need 24 weeks? If you have access and capacity to purchase 24 weeks commence asap. If you have 12 weeks now and the opportunity to purchase another 12 weeks, the same thing. If the test for fibrosis is F3-4 you can order the additional 12 weeks later, once you commence. I’m thinking you have 12 weeks of sofosbuvir and daclatasvir and also your Doctor is wanting you to go with IFN/Riba with sofosbruvir. . DAAs is the way to go mate. Em
21 November 2015 at 9:27 am #4342
Dr James
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@fixhepc
12 weeks

Sofosbuvir+Daclatasvir

or

Sofosbuvir+Ledipasvir

No Ribavirin. No Interferon.

>95% cure rate

YMMV
21 November 2015 at 9:36 am #4343
klhilde
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@klhilde
Good to hear you’re starting treatment.

Don’t forget to come back and tell us how it’s going.
21 November 2015 at 11:56 am #4348
Ahmedova-Dilrabo-dilrabohon1888-twitter
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@ahmedova-dilrabo-dilrabohon1888-twitter
Sure I’ll tell what is my treatment with Daclatasvir production of Bangladesh Julphar Bangladesh Ltd Daclacee and Sofosbuvir from India company Natco. Thanks you all for your support and help. With respect Dilrabo from Tajikistan .Everyone is waiting for my results with the drugs from Bangladesh
21 November 2015 at 12:40 pm #4349
zhuk
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@zhuk
Good to hear Ahmedova, hope it goes well for you.

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 26
23 November 2015 at 1:57 am #4475
klhilde
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@klhilde
Okay, that’s a company I hadn’t seen yet. Sof and Dac available.

http://www.julpharbd.com/
23 November 2015 at 2:06 am #4477
Dr James
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@fixhepc
Yes, we have samples on the way for testing.

YMMV
23 November 2015 at 8:22 pm #4509
Ahmedova-Dilrabo-dilrabohon1888-twitter
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@ahmedova-dilrabo-dilrabohon1888-twitter
dear Doc I would like to know the results , although I started taking Duck Bangladeshi today , but I really want to know the answer to your testing, I hope not mistaken with the order of daclatasvir(Daclasee) , and if possible to find out the date the answers to the test.
15 December 2015 at 7:59 am #6327
Ahmedova-Dilrabo-dilrabohon1888-twitter
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@ahmedova-dilrabo-dilrabohon1888-twitter
Hello here is my analysis for December 10, 2015 and cheers Bangladeshi Daclacee works I have not found the virus sensitivity was 50 copies per ml , why is the platelet count increased to 402 our lab norm from 180 to 400 -10^9/l . I do not know because of what so increased advise what I should do . Thank you sincerely Dilrabo
15 December 2015 at 9:04 am #6329
klhilde
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@klhilde
Hi Dilrabo,

UNDETECTED!!! YAY!!!

While it would be nice to see a quantitative test with lower detection levels (generally 15 copies/mL, one I’ve read is 5 copies/mL) since you are only 3 weeks into treatment, even using a test with a 50 copies/mL threshold is a great result.

Hopefully Dr. Freeman will see this and have an answer about your platelet count, but from what I read Mayo considers normal to be a range of 150-450, and says numbers outside that range “may be a side effect from medication.”
http://www.mayoclinic.org/tests-procedures/complete-blood-count/basics/results/prc-20014088

In any case 402 is just barely outside your lab’s range, so while you do want answers there should be no reason to be anxious about it yet.

My platelet count went up from 208 to 260 and my blood work wasn’t until 6+ weeks into treatment.
17 January 2016 at 12:30 pm #9512
Dr James
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@fixhepc
Your platelet count is normal and nothing to worry about.

YMMV
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