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  • in reply to: Viral Load On Treatment – What To Expect #7854
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    By the way mine VL was big at the beginning.

    In the ION-3 trial (Harvoni GT1, naive, non cirrhotics)

    http://www.hepatitisc.uw.edu/page/treatment/clinical-trials/61

    It was observed that SVR rates were nearly identical for 8 weeks vs 12 weeks treatment where the initial viral load was < 6 million.


    YMMV

    in reply to: Improvements during and after HCV treatment #7852
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi all

    Before diagnosis I was incredibly fatigued and forgetful. Also very anxious and teary. I am now in week 7 and the first thing I noticed was my thinking was clearer……..as time has gone on I feel calmer and much more energised. Only downer is that I am still getting the occasional headache (and they are rippers) but I was suffering with these before I started treatment so not sure if it is connected or not. Sleeping a little longer too so not waking as early as I was (insomnia the only side effect I have).

    All in all I feel 80% better than I did prior to starting my treatment. :)


    YMMV

    in reply to: B12 supplements may improve SVR #7818
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc
    in reply to: Fibrosis/Cirrhosis info corner #7674
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Happy New Year to you all. May 2016 be extra kind to you.

    I have been scrumming through my results over the last 10 months and came across my Fibroscan result. I don’t think the result has ever been explained to me clearly (only that it was “okay”;) so thought I would run it past those of you that may know what the numbers mean.

    Findings: The appearance of the liver is within normal. No focal lesions visible.
    AFRI results:

    ARFI – Median Velocity 1.16 IQR 0.18 The first radiologist
    1.15 IQR 0.11 The second radiologist

    Both ARFI measurement sets are concordant in the less than F2 range. I was always of the opinion that the Fibroscan was F0 but am starting to wonder now if it was read wrong …….. my GP had not had any past experience in these sorts of scans. I did fax it through to Dr Freeman when I sent all my test results to him but forgot to ask him what it meant.(was too excited about staring my treatment at the time).

    Thanks in advance.


    YMMV

    in reply to: Ariel takes the Plunge #7673
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    All the best Ariel……..looking forward to seeing your test results down the track.


    YMMV

    in reply to: Sonix Tx Log #7605
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Sonic I live in Bendigo and can relate to the hot weather Phewww

    I am in week seven on Sof/Led and also have the insomnia and still do but sleeping a bit longer than when I first started. I take my meds at around 8.30pm and find now that I am not tired in the mornings when I get up (work full time) and energy levels improving also. I turned 60 this year and have no idea when, where or how long I have had the virus but I am forever grateful for Dr Freeman and the Buyers Club for the opportunity to be able to take my meds now rather than waiting for an appt at the Liver Clinic at the Base Hospital here (10 months and counting so far)! My four week blood tests came back HCV undetectable :)

    Have a great New Year and I look forward to hearing your results.

    Cheers Lynne


    YMMV

    in reply to: Glossary? #7595
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    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.

    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

    in reply to: Viral Load On Treatment – What To Expect #7594
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Intuitively it is hard to see how <15 and detected can equate to cure and this was certainly my initial thought, but this was rapidly corrected by an expert:

    http://fixhepc.com/forum/experts-corner/104-expert-professor-by-email-september-13th.html

    2) The advice re prolongation of treatment based on HCV viral load monitoring is incorrect. There is no relationship between on-treatment monitoring and treatment outcome (assuming high level adherence, as in clinical trials). In fact, many patients in clinical trials have had “detectable” HCV RNA at end-of-treatment and still achieve sustained viral clearance. There is clearly no relationship between week 4 (or other timepoints) and sustained viral clearance, so extending treatment duration (as we did with interferon-based treatment) does not make sense in the interferon-free era, including in the case described below.

    In the ION trials HCV RNA < 25 was used as the definition of success. http://www.nejm.org/doi/full/10.1056/NEJMoa1402454#t=articleMethods

    http://www.nejm.org/action/showImage?doi=10.1056%2FNEJMoa1402454&iid=t02

    So according to the experts <15 (or <25) and detectable does not have any bearing on SVR. Undetectable is my favourite word but <15 is satisfactory.

    Here is an interesting slide presentation suggesting the 1/2 life of the HCV RNA in mammalian cells may be quite long:

    http://www.iapac.org/icvh/presentations/ICVH2013_Panel4_Soriano.pdf


    YMMV

    in reply to: A New Year in the State Belgium #7573
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Beautiful Life, thank you for sharing your journey and the music. I’m so glad you are doing great and looking forward to the new year. So much emotion with all the sharing and well wishes. I love this group and all of you people. I would never have had the courage to start treatment without you all. Onward, and blessings. :cheer: :P


    YMMV

    in reply to: Anticipation and Thanks #7536
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    The evidence favouring Ribavirin is fading. For GT3 it has faded. With GT1a you would need to be cirrhotic to need Ribavirin and even then 24 weeks Sof/Dac would be my personal choice due to the Riba sides.


    YMMV

    in reply to: Glossary? #7527
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Interferon 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

    in reply to: Switching tx from sof+led to sof+dac – thoughts? #7508
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Thanks LondonGirl. No I haven’t had any treatment before and bad LFT was what led me to being diagnosed, but all okay now at the moment. Of course I am not questioning Dr Freeman’s advice but I just get a bit uncomfortable when I read about some members who are extending their treatment and/or speaking about different combinations. Just me being a worrier I guess…….not so long to go now so fingers crossed. :)


    YMMV

    in reply to: Switching tx from sof+led to sof+dac – thoughts? #7484
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    I am starting to get a bit nervous about whether my treatment is going to do the job after 12 weeks. There has been a lot of conversation about treating for longer and changing the medications to ensure no relapse. I take Sof/Led and have five weeks to go. Should I be worried that I am not taking the medication for long enough? May be worrying over nothing of course…I can be a worry wart at times :)


    YMMV

    in reply to: viral load test #7448
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    This assay has a result range of 15 to 100,000,000 IU/mL (1.18 log to 8.00 log IU/mL) for quantification of hepatitis C virus (HCV) RNA in serum.

    An “Undetected” result indicates that the HCV is absent in the patient’s serum specimen.

    A result of “<15 IU/mL (<1.18 log IU/mL)" indicates that HCV RNA is detected, but the HCV RNA level present cannot be quantified accurately below this lower limit of quantification of this assay. When clinically indicated, follow-up testing with this assay is recommended in 1 to 2 months. To assess response-guided therapy eligibility, an "Undetected" result is required, and a result of "<15 IU/mL mL (<1.18 log IU/mL)" should not be considered equivalent to an "Undetected" result.

    A quantitative result expressed in IU/mL and log IU/mL indicates the degree of active HCV viral replication in the patient. Monitoring HCV RNA levels over time is important to assess disease progression and/or monitoring a patient's response to anti-HCV therapy.

    A result of ">100,000,000 IU/mL (>8.00 log IU/mL)” indicates the presence of active HCV viral replication, and the HCV RNA level present cannot be quantified accurately above this upper limit of quantification of this assay.

    Here is more than you could ever want to know: http://jcm.asm.org/content/51/2/571.full

    The second test is using a different assay (not specified) and once again does not make note of Detected/Undetected status.


    YMMV

    in reply to: viral load test #7446
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Please post the data part of your result.

    The < 12 means we can't count it. This would usually be followed by Undetected or Detected - it can be too low to count, but still detectable, or too low to count because it is undetectable.


    YMMV

Viewing 15 posts - 1,621 through 1,635 (of 1,968 total)