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Viewing 15 posts - 1,531 through 1,545 (of 1,968 total)
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  • in reply to: An observation #10366
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    I think it represents the highly private nature of HCV and a not unreasonable desire not to give any personal details to an anonymous website, at least not without checking it out in detail first.

    If you don’t have forced registration to post then you get over run by spam bots, but then registration requires giving up an email address. I suppose not everyone is familiar with using “burner” email addresses for such purposes.

    I seem to spend half my day clicking the “Unsubscribe” button on emails.

    The actual number is the number of different sessions browsing content in the last 600 seconds. Each device creates its own session so it’s actually a count of devices rather than people, although the numbers are similar. Right now it looks like:

    Users.png


    YMMV

    in reply to: any one else have a co-infection with HVB? #10273
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hello Suzy,

    Many people who get Hep B clear the infection themselves. Those who do not go on the chronic Hep B and will have a measurable viral load.

    This is similar to Hep C, except with Hep C only 15-25% of people clear it without treatment.

    Regardless of you HBV status you can treat HCV.

    If you have chronic Hep B or perhaps what you are calling “sleeping” Hep B it can reactivate.

    It it possible to suppress Hep B (and cure some) with drugs like entecavir.


    YMMV

    in reply to: when can I stop the Riba #10272
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hello Lizi,

    It is hard to see why you need either 24 weeks treatment or Riba.

    There is no such thing as a hepascore of 15 – the range is 0 – 1.0

    If you are GT1b, treatment niave and non cirrhotic your SVR rate is at least 97% (possibly 100%) with 12 weeks treatment.

    Here is all the trial data for Sof + Dac in GT1

    Sofosbuvir Daclatasvir

    NAIVE
    default: svr: 97%, trials: ALLY-2 naive (80/83) experienced (43/44) Aggregate 96.8% (123/127)
    w24: svr: 100%, trials: AI444040 (24wk) 100% (44/44)
    gt1a: default: svr: 96%, trials: ALLY-2 naive 96% (68/71) experienced 97% (32/33) Aggregate 96.2% (100/104)
    gt1b: default: svr: 100%, trials: ALLY-2 naive 100% (12/12) experienced 100% (11/11) Aggregate 100% (23/23)
    F4
    default: svr: 91%, trials: ALLY-2 naive 89% (8/9) experienced 92% (12/13) Aggregate 90.9% (20/22)
    FAIL
    default: svr: 98%, trials: ALLY-2 98% (43/44)


    YMMV

    in reply to: Obama executive order to control drug prices #10240
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    The “no price negotiation” part of Medicare Part D is probably the worst example, but consider:

    Donald Rumsfeld was Chairman of Gilead from 1997 until 2001 before resigning to become Secretary of Defense.

    Several Gilead / Pharma benefiting events occurred during the time D.R. was part of G.W.B.’s inner circle.

    The US DOD begins to stockpile Tamiflu (a barely effective drug) not long after D.R. becomes Secretary of defence.

    http://www.huffingtonpost.com/david-h-newman-md/tamiflu_b_4400584.html

    https://www.vaccines.mil/documents/870TamifluReleasePolicy.pdf

    and although Tamiflu was purchased from Roche, Gilead licensed it to Roche so were a significant beneficiary:

    Gilead receives a blended royalty on sales of Tamiflu, tiered from 14 to 22 percent based on Roche’s annual net sales.

    http://investors.gilead.com/phoenix.zhtml?c=69964&p=irol-newsArticle&ID=783456


    YMMV

    in reply to: ‘In which LG seeks Redemption & makes new friends’ #10168
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    That’s just awful LG. I guess I have been lucky in my journey, my GP is very supportive, medical staff are fabulous and certainly not judgmental. Bendigo Base still haven’t given me an appointment however I have spoken to the Nurse at the Liver Clinic and told her about my generics etc. To say she was excited is an understatement,……everyone I have told about my HepC including workmates have been incredibly supportive….as I said I think I have been very very lucky and it makes me really sad and mad to hear about the way those of you that have been treated badly.

    Keep on keeping on! :)


    YMMV

    in reply to: Flu vaccination #10136
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    I would probably pass on the vaccination. In Australia it is recommended for only a limited number of people:

    http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-influenza

    • Over 65
    • Aboriginal
    • Pregnant
    • High risk patients like severe asthma, heart disease, lung disease, immunocompromised (HIV, transplant), and diabetics

    Unless you’re in one of these groups the arguments to have it are limited, and it typically makes you feel mildly unwell.


    YMMV

    in reply to: New-Onset Diabetes from Ledipasvir/Sofosbuvir #10095
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Having HCV substantially increase your risk of developing Diabetes…

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669937/#!po=1.08696

    Among those at high risk for T2D, persons with HCV infection were more than 11 times as likely as those without HCV infection to develop T2D (relative hazard, 11.58; 95% CI: 1.39-96.6)


    YMMV

    in reply to: New-Onset Diabetes from Ledipasvir/Sofosbuvir #10093
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    If you look at what the CDC has to say about it

    http://www.cdc.gov/diabetes/statistics/incidence/fig3.htm

    You will note that people in the 45-65 age range have an annual incidence of 12 per thousand. That is 3 per thousand per 3 months.

    So all other things being equal 1:300 patients aged 45-65 who are on ANY 3 month treatment will develop diabetes.

    This is not to say insulin resistance and HCV are not related, simply that STUFF, as in all sorts of stuff happens to patients on and off treatment.


    YMMV

    in reply to: Treatment journal a Hep 1b story #10082
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Tiana

    I also have genotype 1b. I only have two weeks left of treatment Sof/Led (12 week treatment). I have suffered from insomnia all the way through but energy levels just keep getting better every day. It’s so nice to to feel like I want to fall asleep at work :) A few headaches but nothing a Neurofen didn’t cure, and yes, lots of water is the key. Sounds like you have had a bit of a rough trot to start with but I’m sure it will only get better and better as you go along.

    Keep on keeping on. :)

    Cheers
    Lynne


    YMMV

    in reply to: VA in USA urged to invoke emergency powers #10071
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Would it be technically possible to have a little button next to each post that says something like “Hide/Unhide” or “Shrink/Enlarge”? This would then minimise the message to show only the first line or two, for example?

    At the moment I don’t think that exists. It probably could. I guess you had something in mind for the readmore like this spoiler where it is collapsed until you open it. The technical problem is that this won’t speed download times because it’s still there (downloaded), it’s just being hidden.

    Spoiler for
    Here is some text

    And some more text

    And some more text


    YMMV

    in reply to: Once upon a time… #10040
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    I have been doing a bit of filing work creating subsections where that are a lot of posts in that section relating to a similar idea. Most of the work has been in the experts corner so far, but I think it’s getting a little easier to find stuff.

    The search widget in the top bar searches both the site and the forums. The forum search only covers the forum.


    YMMV

    in reply to: Do not worry Detected or Undetected if below LLoQ #10003
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    At SVR4 there is a 96% chance you never have detectable virus again
    At SVR12 it is 99%
    At SVR24 it is 99.9%

    So if the HCV is not back within 6 months of EOT you have a 1000:1 chance of never seeing it again, and going on to die of ripe old age.

    Personally I’d call that cured.


    YMMV

    in reply to: Treatment arrived yesterday #9834
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    1 round of DAAs is going to feel like 1 round with a powder puff rather than 2 rounds with Mike Tyson.

    For GT3 it looks like this:

    Sofosbuvir Daclatasvir

    NAIVE
    default: svr: 97%, trials: UN-NAMED IIb (24wk) 89% (16/18) ALLY-3 97% (73/75) AASLD-2015 96% (24/25) Aggregate 97% (97/100)
    w24: svr: 100%, trials: AASLD-2015 100% (29/29)
    F4
    default: svr: 65%, trials: ALLY-3 58% (11/19) AASLD-2015 70% (23/33) Aggregate 65.4% (34/52)
    w24: svr: 90%, trials: AASLD-2015 86% (116/135) overall but Child-Pugh A 90% (90/100)
    riba24: svr: 81%, trials: AASL-2015 81% (39/48)
    FAIL
    default: svr: 86%, trials: ALLY-3 94% (32/34) AASLD-2015 86% (89/103) (bias by F3/F4)
    FAIL+F4
    svr: 64%, trials: ALLY-3 69% (9/13)
    w24: svr: 86%, trials: AASLD-2015 86% (89/103)
    riba24: svr: 80%, trials: AASLD-2015 80% (28/35)


    YMMV

    in reply to: isaing4 Twinvir story #9833
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    If my viral load is not UND at 6 weeks, half treatment…
    Maybe it is recommended to prolonged the treatment with 4 weeks, with a total of 16 weeks?
    I don’t know, I am a little bit disappointed. :unsure:
    Any advice will be appreciated.
    Thanks! :)

    You are 1b F0-1 and treatment naive. That gives you a 99% chance of SVR with 12 weeks Sof/Led:

    ION-1 100% (67/67) ION-3 98% (43/44) Aggregate 99.1% (110/111)

    Not bad odds.

    To reassure you here are some real results from a patient of mine…

    Week 0 7.8 million
    Week 2 598
    Week 4 76
    Week 5.5 < 15 Week 8 0 Week 12 0 SVR 4 0 SVR 12 0 Lots of testing because she was a doctor and one of my first patients. 5.5 weeks because she went on a cruise! Personally if I wanted an insurance blanket I would add some Simeprevir rather than treat for longer. The odds are on your side and you are chasing the last 1-2%. http://fixhepc.com/forum/experts-corner/602-100-dare-to-dream-the-impossible-dream.html


    YMMV

    in reply to: power of 3 #9825
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Great article Hazel, you girls are agitating real well over the ditch. Tell em all.to come over. The supply chain looks solid so no need really if doctors are willing to prescribe. Hopefully this article will convince more to come on board

    Hi Emlio,

    It’s been quietly happening for a while, baby steps but gathering momentum…

    Hi James

    Yes some good news for all Australian Hep C patients.

    We have written scripts for 4 patients here before Christmas, but I don’t know how many have gone through with signing up to the buyers club etc.

    We have a compounding pharmacy in Auckland who has compounded a few other buyers clubs meds as prescribed by a local gp.

    Hopefully NZ government will also get such a good price, I haven’t heard any news as to when this might be reconsidered. If its gradually introduced ie cirrhotics first Im sure there will still be ongoing interest in buying.

    Thanks for the trial link. We have another one this afternoon who wants to buy so will discuss Redemption etc.

    Cheers

    Dr at major NZ referral hospital


    YMMV

Viewing 15 posts - 1,531 through 1,545 (of 1,968 total)