Hello beaches,

Please get her to email me james@fixhepc.com and we can help arrange things for her.

In a perfect world we do all this: https://fixhepc.com/what-your-doctor-needs.html

If you are seeing a doctor about getting a prescription you can save yourself time, money and hassle if you bring all the things that are required.

Your doctor will need to know:

Genotype (1 to 6 with or without a and b)
Fibrosis by scan or biopsy (either as F score or kPa) or by APRI (from blood tests CBC and LFT)
Hepatitis B status
Prior Treatments – what and when
Current Medications

While you doctor can look these up (provided you know where they were done) it saves a lot of time if you have copies but if you don’t have copies, don’t worry.

Each of these impacts on the best choice of medications and duration.

Daclatasvir interacts with some common medications.

Routine tests pre-treatment

Full Blood Count
Liver Function
Creatinine
Electrolytes Urea
Viral Load
Hep C surface Antibody, Hep C core Antibody +/- Hep B surface Antigen (for core positive, surface negative chronic Hep B patients)
AFP (Alpha Feto Protein) – a screen for hepatocellular carcinoma

I can find the before, but not the after.

Patients with HCV are known to have higher Intra Occular Pressure (IOP) and other issues. IOP is measured with tonometry:

https://www.ncbi.nlm.nih.gov/pubmed/23470265

RESULTS:
HCV-infected patients presented an almost four times higher risk of lacrimal function involvement by tear break-up time [odds ratio (OR)=3.76; 95% confidence interval (CI) 1.75-8.04, P=0.001] and Schirmer’s test (OR=4.17; 95% CI 1.83-9.50, P=0.001) than the controls. The chances of palpebral biomicroscopic lesions (blepharitis) were also higher (OR=3.21; 95% CI 1.49-6.94, P=0.003). Mean tonometry was higher in HCV patients (right eye 14.4±2.3 vs. 12.2±1.5, P<0.001 and left eye 14.5±2.3 vs. 12.0±1.4, P<0.001).

Hi John,

Why don’t you book in with me on https://gp2u.com.au/ and we can run through all your worries?

Hello Vedruss,

With end stage liver disease (ESLD) there is no doubt that some of the issues realted to the “hepatic encephalopathy” aka dysfunctional brain, relate to toxins from the gut. Lactulose is used to help “flush them out”

With the average Hep C patient, this is not a factor, and exactly why patients have “brain fog” is something of a mystery. This article may make your eyes glaze over but, in short, HCV does get into the brain at low levels and cause problems:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840160/

The good news side is that when you treat HCV the vast majority of patients report “Hey, my brain is working again and now I can do stuff!”

Here is another article:

https://onlinelibrary.wiley.com/doi/full/10.1111/apt.14594

Which concludes:

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.

So not only do patients notice this issue, the boffins with their machines that go ping, can see that Hep C definitely causes issues in the brain.

Hi beahavan,

When we medicalise everything we tend to forget that the solution to life problems is rarely found in the bottom of a bottle.

Good friends and relationships, a good diet, enough sleep, not too much alcohol, not smoking, keeping your body weight in check, and some regular exercise all combine as the major contributors to good health.

Occasionally, like with DAAs, pills can make a massive difference, but that’s the exception, not the rule.

Hello Mark,

Yes, the single genotype test comes back with the results, and this is usually one genotype.

Talking about doing something is a popular political past time across the world!

Sometimes I wish politicians would actually just do nothing, but in this case we need action, not words.