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Hi Serg
I agree to respectively disagree with the likes of Roy M Poses about his extreme views on EBM.
There are always extremist views within any given profession and a tsunami of data on any given subject.
The trick is to separate the wheat from the chaff.
I wish you the best in deciding on the appropriate HCV treatment for your circumstances based on an acceptable degree of confidence according to your criteria.
GT2
1983: Hospitalised with Acute non-A, non-B Hepatitis after ICU blood transfusion 3mths earlier => HCV GT2
22/02/16: (pre-tmt) ALT 61, VL 2.48 IU/ml Hepascore 0.32 (F1/2), fatigue, brain fog, bloating (Treatment Naïve)
10/04/16: (Start tmt) Sofovir +DaclaHep (SOF + DCV) by Hetero Labs in India
09/05/16: ALT 34, VL: NOT Detected
🙂 , FBG 11.9 
17/6/16 FBG 5.7; PPBG (@14.22) 6.9 (@ 20.45) 7.1; BP 124/72
🙂 (Accu-Chek Mobile & Omron Auto BP Monitor) 🙂Well, arguing about SVR as being a cure or not for HCV, reminded me the following joke from several years ago when the bird flu was a hot topic:
In a certain small village people were asked to sacrifice all of their chickens in order to prevent the spread of the bird flu.
Some did so, some did not. One of those people who did not sacrificed his chickens was asked:
-Q: “Why did not you sacrifice your chickens?”
-A: “Well, I was not sure (aka I have no solid evidence) whether the living creatures from my yard are really chickens, no veterinarian came to me to confirm me that it is really chickens”Going back to the topic of cure or not, there are various debates that related to treating HCV, it is questionable to discuss about “cure” or SVR, because literally, “cure” implies that the virus is gone and the liver returns to the normal status (no fibrosis). As long as after reaching SVR the fibrosis is/will be reduced, but is not completely vanished, “cure” might be perhaps too much for some peope. So SVR seems to be a more accurate term.
No matter whether we talk about SVR or cure or whether some small HCV RNAs exists somewhere in small quantities, as long as there will be no more “destruction force” against the liver, I can live very fine with SVR12/SVR24,SVR48, or any other “N” number you put after SVR as long as N>=12
.Cheers,
RHF
Thanks RHF, excellent points that got me thinking about other diseases that are often considered curable or cured. So I googled the definition of “cure” and found the following.
“When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean — neither more nor less.”
― Lewis Carroll, Through the Looking Glass
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
“The question is,” said Alice, “whether you can make words mean so many different things.”
“The question is,” said Humpty Dumpty, “which is to be master—that’s all.”
Humpty appears in Lewis Carroll’s Through the Looking-Glass (1872), where he discusses semantics and pragmatics with Alice
1983: Hospitalised with Acute non-A, non-B Hepatitis after ICU blood transfusion 3mths earlier => HCV GT2
22/02/16: (pre-tmt) ALT 61, VL 2.48 IU/ml Hepascore 0.32 (F1/2), fatigue, brain fog, bloating (Treatment Naïve)
10/04/16: (Start tmt) Sofovir +DaclaHep (SOF + DCV) by Hetero Labs in India
09/05/16: ALT 34, VL: NOT Detected 🙂 , FBG 11.9
17/6/16 FBG 5.7; PPBG (@14.22) 6.9 (@ 20.45) 7.1; BP 124/72
🙂 (Accu-Chek Mobile & Omron Auto BP Monitor) 🙂
1983: Hospitalised with Acute non-A, non-B Hepatitis after ICU blood transfusion 3mths earlier => HCV GT2
22/02/16: (pre-tmt) ALT 61, VL 2.48 IU/ml Hepascore 0.32 (F1/2), fatigue, brain fog, bloating (Treatment Naïve)
10/04/16: (Start tmt) Sofovir +DaclaHep (SOF + DCV) by Hetero Labs in India
09/05/16: ALT 34, VL: NOT Detected 🙂 , FBG 11.9
17/6/16 FBG 5.7; PPBG (@14.22) 6.9 (@ 20.45) 7.1; BP 124/72
🙂 (Accu-Chek Mobile & Omron Auto BP Monitor) 🙂 If i correctly understand, it may be possible another interesting thing with semantics. If majority of HCV-infected people will not develop cirrhosis and complications of cirrhosis, extrahepatic manifestations during lifetime without treatment – then, HCV infection is not a “disease” for these majority of people. Hence, really, they are “healthy” people, despite they are infected. The “treatment”, for many people, really, is “prophylaxis” of “diseases” (cirrhosis/extrahepatic manifestation) in a “healthy” person.
No.
– Hepatitis C is the disease.
– Cirrhosis/extrahepatitic manifestations are symptoms.
– it is possible to have a disease without displaying obvious symptoms.
I’m sorry but if you believe otherwise it is not semantics but misunderstanding.
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
Symptoms such as cirrhosis, etc. are subjective indications or signs of disease. They may or may not be present now or in the future and may or may not be due to a particular disease.
On the other hand a disease such as HCV can be defined by objective means such as a PCR test.
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
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