Hello Hope8,

Welcome to the forum.

Undetectable at 4 weeks is definitely on track!

You are correct that with GT 1a the benefits of adding Ribavirin to Harvoni are minimal. In the context of 24 weeks treatment there is, IMHO, unlikely to be any benefit.

On the topic of Ribavirin the recommended dose is 15mg/kg of body weight, but typically simplified as 1000mg/day for patients < 75kg and 1200mg/day for patients > 75kg. This is usually given as 2 doses. So, that means the dose you are taking is relatively low.

The half life of ribavirin is long so it takes about 21 days to get to its maximum. That means we need a few weeks to see how its going to land side effect wise. You have probably landed but, personally, I monitored the FBC/CBC of my ribavirin patients every 2 weeks. The monitored related to the fact I have not used ribavirin for going on 2 years because… we just don’t need to and the treatment journey without it is generally much smoother.

Without knowing your pre-treatment status it’s hard to give specific advice but we do know:

For treatment naive patients with GT1a using only 8 weeks Harvoni is *almost* as good as 12 weeks

The results for GT1a with 12 weeks Harvoni are very good, with patients with cirrhosis or HCC being the only common exceptions

In ballpark terms for GT1a

8 weeks Harvoni => 90% cure
12 weeks Harvoni => 95% cure (+5%)
16 weeks Harvoni => 97.5% cure (+2.5%)
20 weeks Harvoni => 98.5% cure (+1%)
24 weeks Harvoni => 99% cure (+0.5%)

The point here is that a) each extra 4 weeks treatment does add to treatment success rates; but b) there are diminishing returns in terms of extra cure rate.

Do you have any of your pre-treatment bloodwork and tests?

Hi Violet,

The Moderna vaccine available in Chemists is probably slightly better than Pfizer and probably easier to access. The main risks with mRNA vaccines are allergic reaction and myocarditis (almost all young people). The clotting risk with the AZ vaccine has been totally overblown in both the media and people’s minds.

Looking at my family, different family members have had all 3.

For Pfizer and Moderna (both mRNA vaccines) the duration of protection appears to relate to how long you wait between doses. In line with expectations a longer delay between doses (ie 6 weeks) is better than 3 weeks.

This fits with what we see with pretty much every other vaccine. Yes you can rush the dose schedule (with going on holidays being the common reason back in pre-covid days). The consequence of rushing the schedule is that the protection is not quite as good or quite as long lasting.

Hi Perecarl,

Sorry for the delayed response. In my other life I founded a Telehealth company that I’ve just completed selling.

Anyway I would not expect you to be able to donate plasma. The presence of antibodies to HCV is one of the exclusion criteria. This is from the Red Cross in Australia but is representative of the policies around the world.

https://www.lifeblood.com.au/faq/eligibility/medical-conditions-and-procedures/hepatitis

Hepatitis C:
If you currently have or have ever had hepatitis C, you aren’t able to donate even if you completed successful treatment. 

One of the screening tests for hepatitis C tests for the hepatitis C antibody, which usually remains positive for life. Donations can’t be used if they test positive to any screening test for an infectious disease.

Don’t be disappointed though, because there are other ways you can help. You can spread the word about how blood saves lives on social media (find us @lifebloodau), register your intent to be an organ donor (if you’re 16 or over), or support the great humanitarian work of the Australian Red Cross.

Hi Sven,

While laboratories tend to report a single genotype, about 10% of people are probably infected with 2 genotypes:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296219/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205070/

We have seen people treated for GT1a with Harvoni relapse with GT3 despite a negligible reinfection risk so presumably, they had both GT1a and GT3, and the Harvoni only cured the GT1a leaving the GT3 to flourish.

Here is an image of some actual genotype testing:

Lanes 1 and 2 are GT1. Lanes 3-5 and 7-10 are GT3. Lane 6 is negative. Lane 11 is the control.

Look carefully at lane 8 and notice that while GT3 is dominant there is a clear GT1 line below it. Some of the other GT3 lanes also suggest GT1 but lane 8 seems pretty clear. That result would be reported as GT3 but is really GT3/GT1

So, it is possible that somebody infected with 2 genotypes can pass on both, and that in the other person a different genotype is the dominant one.

Ledipasvir is not effective against GT2 or GT3 so, for a patient coinfected with GT1/GT2 or GT1/GT3 the Harvoni should cure the GT1 but there is only a 70% chance of curing the GT2 or GT3 (because Sofosbuvir alone has about a 70% cure rate for these).

Hi Sven,

Sofosbuvir+Daclatasvir or Sofosbuvir+Velpatasvir both work on 2b

With cirrhosis Velpatasvir is preferred.

Maviret is also good but as yet there is no generic.

Hello Gan,

While it is possible treatment of your hep C may improve the hair situation the reliable benefits we see for patients with the fatigue, brain fog and confusion you report are that these almost always completely disappear.

The phrase “I have not felt this good for 20 years” is a very common sentiment after people have treated and been cured.

Best Wishes

James

Hello Sonja,

There are almost no good reasons not to get vaccinated. All the vaccines that have made it to market are much safer than actually getting Covid.

To answer your question specifically fibrosis is not a reason to avoid vaccination.

In terms of waiting for better options, the options we have now are pretty much as good as it ever gets in terms of safety and efficacy.

No vaccine is 100% safe and 100% effective but then again, COVID is 2-3% fatal and close to 100% of people will get it (in the absence of a vaccination).

Hello Aneela,

Welcome. The answer depends on which medication you are taking…

Can you share that information please?

Best Regards

James