Yes, it won’t just disappear, but there is good reason to be optimistic about fibrosis regression…

SVR After Therapy Reduced Inflammation, Fibrosis in HCV Patients

“The observations of the present study strongly suggest that fibrosis regression, including resolution of cirrhosis, will occur in the vast majority of patients who will achieve SVR with these future therapies.”

At SVR the processes driving fibrosis should stop so things should not get worse and over time there is evidence things improve for many patients.

Please don’t wait a few days or your medications will either be destroyed or returned to sender.

You need to send customs the email and documents listed here: http://fixhepc.com/getting-treated/how-to-do-it/import-paperwork.html

Customs need the missing documents supplied or they will not clear the shipment.

It’s relatively rare, but if your GGT does not come down to normal I would change the Naproxen to a different NSAID.

This is a really good site for looking up if a drug might impact on your liver http://livertox.nih.gov/

http://livertox.nih.gov/Naproxen.htm

When a doctor orders Liver Function Tests (LFTs) what we get back looks like this (really simplified):

• Bilirubin and ALP – this is a measure of how well the liver is draining and go up with cirrhosis
• Protein/Albumin – this is a measure of how well the liver is working making stuff
• GGT/ALT/AST – these are all liver cell enzymes that go up when liver cells die and release their innards

So with hepatitis you see high levels of GGT/ALT/AST.

If you had say a gallstone blocking drainage from your liver we would see high bilirubin and ALP. There might be a small increase in GGT/ALT/AST as well due to the blockage injuring the liver cells, but usually not as much as you see with hepatitis.

So getting to your question. A change of +/- 10% is not typically significant. Your GGT has fallen by 45% so that does likely represent less liver cell death.

Time also plays a part. GGT is typically raised in people who drink a lot. We know that if they stop drinking (which is the cause) it can take up to a month for their GGT to return to normal.

In my experience a 2 weeks we see improvement (but not normalisation) of liver enzymes. Viral loads that have been 1,000,000 show a log 4 drop (circa 10,000 times) to below 100. I have seen 2,000,000 -> 18 in 12 days (by way of example)

At 4 weeks previously abnormal liver functions are often totally normal, and there is no viral RNA detectable.

So in short don’t be disappointed to see elevated LFTs and a 15-50 viral load at this point.

You should also note that the viral load tests are done on Monday and Wednesday nights, so if you had blood taken yesterday it won’t make the Monday night run so Thursday would be the earliest time a result might be available, but it could be Tuesday week.

Forums are public by nature but an email to james@fixhepc.com will arrive in my inbox without passing through any other hands.

Patients can also call the 03 8672 7825 number and if they can’t get through to one of our doctors immediately leave a number and a good time for a call back.

Big chunks of this site are generic answers to frequently asked questions, so it’s a great help to get direct feedback about what needs to be explained better.

Not yet. We have samples from several manufacturers en-route for testing.

Mesochem is still open for business, but they do want to batch things up. We are going to set up a buyers club to facilitate that so people can make an order that will include not only supply but also testing. Price should still be able to be the same because even though we will have to spend a bit on the testing, there will be savings on shipping and Mesochem will give us a few dollars off for making their life easier.

Making a medication is not a lot different to a chemistry experiment or for that matter a back yard meth lab. Typically you add two chemicals together in a solvent, heat it to such an such a temperature for a while, do something to make what you want separate from what you don’t, then rinse and repeat.

What this means in practical terms is that at the end of manufacture you have a lot of the thing you want (which is the > 99%) and a whole lot of traces of things you don’t want, but can not easily separate. Traces of solvents (from the process), traces of metals (from the containers used in manufacture), and traces of molecules similar, but not identical, to what you have been trying to produce.

Here is the official Chinese analysis of Mesochem’s Sofosbuvir API http://fixhepc.com/images/coa/COA-Sofosbuvir.pdf

Yes, if you look at Daclatasvir it is recommended for all types, including 2 and 3. Like ledipasvir it’s an NS5A inhibitor so you could intuit it’s a better one.

The ALLY-2 trial in HIV co-infected patients is impressive, but the numbers remain small so it could be random statistical margin of error, or it could be real.

Time will tell. I would be surprised if Daclatasvir ended up being shown to be inferior, but….. the jury is still out.