Hello beldemire,

This should be fine. The main issue with Sofosbuvir/Ledipasvir (which is what’s in Harvoni and Hepcvir L) is that it needs stomach acidity for absorption so antacids and anti-acid medications should not be used (if at all possible).

Would I be right that you take the medication in the morning and the Serenity Restful Complex in the evening to help with sleep?

Hi Sven,

What a great thought to symbolise the end of Hep C!

Hello Radover,

Your aunt will have no safety issues taking antivirals. You can actually give them at the same time as chemo and the SVR12 (cure) rate is the same for the Hep C.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123740/

With a liver in “good shape” the treatment should be straightforward.

For most patients with Hep C treatment delivers meaningful real-time improvements in quality of life as well as long term benefits.

The reason the virus can reappear is that the <15 undetected means <10 - ie 0-9

0 viruses remaining is cured

1+ viruses remaining is probably not

We can't measure down low enough to know it's all gone, so what we do is

1) Wait 1 week for all the medication to wash out of your body
2) Wait another 11 weeks for the virus (if still present) to grow back
3) Test at 12 weeks in which case <15 suggests (with 99.7% certainty) that there is no virus growing back BECAUSE it was all dead back at EOT - we call this Sustained Virological Response (SVR) at 12 weeks (SVR12).

At SVR24 we are 99.99% certain you are cured and the 0.01% is probably re-infection.

Hello Bobraas,

Tests themselves don’t cure you so they can all be viewed as optional.

Testing 4 weeks into treatment is when we expect the virus to be undetected (78% of people will be undetected at this time). It can be useful as we know from our data, and VA data that the 22% of patients still detected form 44-50% of the treatment failures so it can be worth considering a small 4 week treatment extension if this is the case.

Psychologically it’s nice to see undetected @ 4 weeks. The PCR RNA test is expensive so can be skipped as we also see the ALT and AST in the CMP (Complete Metabolic Panel) fall dramatically – this also show you the meds are working fine and is cheap.

At the end of treatment (EOT) the PCR is not really required – once it is negative it will stay negative. The CMP gives EOT AST/ALT levels which allow us to have a sneak peak once the medications finish. If these numbers stay down all is well.

12 weeks after the tablets finish is the point we call SVR12, standing for Sustained Virological Response. When the tablets finish they wash out of the body almost completely within a week giving any remaining virus 11 weeks to grow back. If it remains undetected we are 99.7% certain that will remain permanent.

At SVR24, 24 weeks after the tablets finish, the virus has has 23 weeks with no drugs to stop it. Undetected at this point is 99.99% certain of being permanent and the 0.01% is probably reinfection.

Meds from Greg should be good.

If you have Hep B and surface antigen is detectable we need to add in another medication. Entecavir or Tenofovir.

Hi Splitdog,

Yes, we can declare you cured.

2nd time lucky!

Thanks for you contributions here over the years. Many people find the whole DIY generic import business a bit too good to be true, but posts from patients like you over a period of years makes it hard to deny the journey and the working…

Best wishes

James

Good luck Tanya, hopefully it’s something else, not a relapse. Either way we need to work out what’s making you feel sick.