Hello Howard,

When did you finish the Maviret?

It certainly needs looking into. We do see some bilirubin rise with both Viekira and Maviret and this we ignore because it happens to most patients and goes away after treatment.

Both AST and ALT are released by damaged muscle as well as liver so we do see this happen occasionally in athletes.

Any drug can cause some liver toxicity (including Maviret) in rare individuals.

The list of causes of liver enzyme increases is quite long – here’s the Mayo version:

https://www.mayoclinic.org/symptoms/elevated-liver-enzymes/basics/causes/sym-20050830

You and your doctor are going to need to work through that list.

If you have a positive surface antibody then you should be immune to Hep B. Your positive core antibody shows this is from past infection. This surface antibody wipes out the surface antigen that Hep B produces (in excess) in patients with chronic Hep B. So it’s really unlikely to be Hep B – the virus can’t assemble without the surface antigen (this is actually part of the stucture of it).

I have seen CMV reactivation do this, but as you can see from the Mayo list there are lots of causes that need to be excluded.

Diabetes is 3x more common in patients with Hep C and it is common full stop. Your 152 suggests you are probably going to be diabetic but should just be checked a few times before doing anything. High blood sugar causes damage over decades and 152 would be pretty good for a diabetic (on treatment) so there is no need to panic about this.

Hello tototo,

Hep C infects not only the liver. It infects many other things including your brain and nerves.

We commonly see cognitive impairment (aka brain fog), fatigue and untreatable depression in patients with Hep C.

These other impacts of Hep C are called the extrahepatic manifestations and here is a good article about them:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735500/

Specifically on the brain, there is something called “functional brain imaging” that shows how a person’s brain is working. A Google Search for “functional brain imaging hepatitis c” will bring up articles like:

https://neuro.psychiatryonline.org/doi/pdf/10.1176/appi.neuropsych.17080163

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5272938/

https://www.ncbi.nlm.nih.gov/pubmed/29536563

The last one concludes:

CONCLUSIONS:
Patients with chronic hepatitis C exhibit cerebral metabolite alterations and structural or functional neuroimaging abnormalities, which sustain the hypothesis of hepatitis C virus involvement in brain disturbances.

In English, Hep C messes with patients brains, and not in a good way.

Hello Hopeful425,

Your experience is not that unusual. There is a lot of virocide going on with the drugs killing off the Hep C. As this happens you liver, brain and other things the Hep C has been attacking start to get back into 100% working order.

I’d suspect you are on the hump about the roll down the hill with smooth sailing ahead.

Excuse the mixed metaphors!

We see insomnia quite commonly (about 1:5) with Sofosbuvir based medications. It’s less for Mavyret but still happens.

You can use sleeping tablets if required. Melatonin 4-6mg about 1 hour before bed works for some people.

There should not be any interaction problems with routine sleepers but you can check drug interactions here:

https://www.hep-druginteractions.org/

Just select Mavyret (Glecaprevir/Pibrentasvir) in the first column and then (say) Temazepam in the second.

Here’s a report for a lot of the routine sleepers:

Hello Anton,

It would be a good idea to see a local doctor about this. It is unlikely to be related to the medication and should be considered on the basis of being a 40-50-60 year old man? who has had some dizziness and dash (fast?) heartbeat.

The medications only treat Hep C. They do not provide any protection from all the other diseases that impact people so you should talk to a doctor about the dizzy feeling and fast heartbeat. There is a condition called atrial fibrillation that becomes increasingly common with age. This can produce dizziness and a fast irregular heartbeat.

Please make the time to see a local doctor and explain what you have noticed to him.

Welcome to the forum Hopeful425,

You’re right that continuing B12 is important for a vegetarian and you definitely should continue this.

The problem with “one size fits all” information is that it does not.

What supplements are you taking at the moment and what are the reasons/expected benefits? Also what other medications do you take (if any).

Hello JOSIE64,

With any luck, it will pass. There are some patients who get fatigued on treatment. All the drugs are pretty clean, and Maviret seems at least as clean as average but a few people do get tired on treatment.

You may find any and all of drinking more water, vitamin D and vitamin B supplements help.

Are you due to see your doctor for a week 4 test?

Hello Miodrag,

The quick answer is sperm take 74 days (about 10 weeks) to grow from nothing to ready to go.

The drugs leave your system very quickly and are almost completely gone in 2 weeks with less than 1/10,000th left. There is less than 1/1,000,000th left after 3 weeks.

So at the SVR12 cure result (at about 13 weeks) you will have had no drugs in your system for 3 weeks + 10 weeks to make brand new sperm so you could celebrate that date in two ways.