Hi John, needs more expertise than I have but I recognise that going crazy trying to figure it all out so here are my thoughts in the meantime:
Gen 1 B is the jackpot, congrats, highest cure rate, and they are all good these days.
Weight shouldn’t make any difference to cure. I lost about 20 kg on treatment- I needed to, another 10 or so would be good, but it was certainly high at the start. Being well, almost straightaway, helped make decision making easier. I have seen all shapes and sizes go through treatment over past 2.5 years.
Really, the disparity in tests shouldn’t make too much difference either, only to the length of treatment you take, and I would try not to worry about it- the thing is to get treated asap. I had cirrhosis for 18 years, confirmed through biopsies and scans, and when I started treatment my liver stiffness was 40kPa so it was a sad old rock. My spleen was enlarged, tumour markers up, ALT climbing.
It has all melted away, I could feel it and have the scan evidence. My liver is now 95% F0, with one rough edge around the F2 mark. I had been told, still see people told all the time, this is impossible. We are rewriting possible with these DAA’s.
What matters though, is how we feel- I felt better in a few days, obviously I wasn’t, for a while, but I am now, it’s still incredible and I just love seeing other people start, succeed. Looking forward to hearing you have got the meds started. Don’t put off for weight loss.

Hi John,

If you have not had the Hep C that long then chances are your fibrosis is relatively low.

With GT1b 12 weeks is long enough and with insurance coverage, they should give you Vosevii if you fail the first round so you have a good plan B. An extra 4 weeks insurance is nice for peace of mind if it’s going to worry you.

Here is a copy of my eBook on weight loss. The key for most people is getting enough protein rather than low fat or low carb. Anyway I’ve taken people from 300 pounds to 160 so it can certainly be done.

The normal and no mass detected is about as good as it gets.

For patients with cirrhosis the risk of HCC is about 3% a year, but it does not sound like you are there.

Thanks Doc. I will denote my TO DO List to be thankful, happy, and commit to help others with HCV.

Hi John,

2 kgs a week is a crash diet.

You need about 18,000 Calories a week, there are 9000 in a kg of fat so 1/2 rations == 1 kg/week

Please read the eBook I attached to https://fixhepc.com/forum/fibrosis-and-cirrhosis/1827-issues-with-exam-results.html#26041 – I do a lot or work with patients to help them lose weight. In the book are the things that work.

You need 1g/kg of body weight as pure protein to prevent digesting your own muscles and as a result lowering your metabolic rate. For a 50 kg person, that is the equivalent of 1 x 200 g steak/chicken breast/piece of fish to deliver 50 g of protein. For a 100 kg person, it is double and for someone heavier it is even more.

The bottom line is simple. It is not low carb. It is not low fat. It is calorie deficient, protein adequate that delivers sustained weight loss.

The vast majority of patients with fatty liver disease are fat. Not sure how to sugar coat as in these PC days you’re not actually allowed to say “This medical problem exists because you are overweight”. We force feed geese carbohydrate to make their livers fat so we can make them into pate. We do the same with cows to make the meat marbled. Anyway, fatty liver disease generally gets better if we cure fatty person problem surrounding the fatty liver.

Fatty liver causes fibrosis and cirrhosis so reducing it makes sense in context using weight loss as the tool.

Your #1 priority is to get the hep C treated. Your #2 priority is to get your weight down into the healthy range.

The #0 priority, that comes before all is “Happy wife, happy life”.