Thanks Amr,

With SVR here is the bottom line – you are 3 times LESS likely to die, 5 times less likely to get liver cancer, and 10 times less likely to get liver failure. That all sounds worth chasing.

Hi don-joe,

Anxiety upsets the stomach. The “butterflies in the stomach” feeling when we are anxious is totally real and relates to your body diverting blood from your guts to your muscles ready for fight or flight.

Antibiotics upset the stomach and guts killing off a lot of good bacteria. Some probiotics for a few days while taking and after finishing are a good idea. Yoghurt and fermented foods are natural sources of probiotics and taste better than the pills full of “good bacteria” (which are basically rubbish).

You don’t need probiotics for life. They are like lawn seed – you seed the lawn and it grows, and it does not need more seed unless you spray the lawn with Roundup. This is the same with antibiotics on the gut.

One of the best cures for anxiety is some strenuous exercise. This burns off the adrenaline and nervous energy and gives you a nice endorphin high after – give it a go…

Hi Don-Joe,

Your urine was not dark because of liver problems – these cause elevated Urobilinogen and Bilirubin.

It would have been dark from being a bit dehydrated is all.

Hepatitis B is much more infectious than HIV or Hep C, however, it’s pretty difficult (but not completely impossible) to get from oral sex.

The best protection is vaccination. If you are not vaccinated for Hep B just do it.

It’s good to know that 95% of all adults infected with Hep B will get rid of it themselves without any assistance.

Then it’s good to know that, even in the most endemic areas in Asia the carriage rate is only 10% (<1% in most Western Countries).

And of those people with it, most (90%+) will be in immune control with no viral load (so not infectious)

So in numbers

Maybe a 5% chance of coming across it
Maybe a 0.5% of coming across somebody viremic
Maybe a 0.005% of getting it
Maybe a 0.00025% of keeping it

Call that 2.5 chances in 1 million. You are much more likely to die in a car crash this year.... If you live in the USA you are 10 times more likely to be murdered...

Do get vaccinated though, it will put your mind permanently at rest, and remember.....

If you can't be good, be careful!

Hi Don-Joe,

Take a chill pill and relax, it is virtually impossible to catch Hep C from sex. Full stop.

In terms of things you can catch from unprotected sex you’ve been treated for pretty much all of them with those antibiotics.

In terms of being a hypochondriac and participating in activities that cause you worry… it’s probably a case of less is more for you. Have protected sex and don’t worry. Get a nice girlfriend/boyfriend and have lots of unprotected sex, but if you’re going to do it with a random take some precautions.

Yes you can take esomeprazole with Viekira: https://www.hep-druginteractions.org/checker

Coadministration has not been studied. Esomeprazole is a substrate of CYP2C19 and CYP2C9 and concentrations may decrease due to induction of CYP2C19 by ritonavir. Exposure of omeprazole, a model CYP2C19 substrate, decreased by 40-50% with ombitasvir/paritaprevir/ritonavir + dasabuvir. Use higher doses of esomeprazole only if clinically indicated.

The Viekira may reduce the effect of the esomeprazole but the esomeprazole won’t hurt the Viekira.

Most people taking Viekira with Ribavirin tolerate it fine. The commonest side effect would be fatigue. Riba rage (a sort of irritability) happens to some.

Thanks for the kind words!

It’s sad that everyone who needs the treatment is not getting it, but we have a policy….. saving the world one patient at a time. We may not make a big dent but doing something beats doing nothing.

You antibodies will remain positive for years, and possibly forever.

The only things that effect your stool colour are:

1) What you eat (fatty foods make lighter stool, dark coloured foods can make darker stool, iron makes black stool)

2) How much bile is mixed in (more bile = dark, less bile = light)

3) Bleeding into your GIT (black foul smelling and tarry)