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but don’t lose sight of other heath issues
This is really good advice beahaven. Treatment for Hep C provides zero protection from every other disease under the sun (except Hep C) so if you’ve stopped the pills and are SVR and there is something odd happening it should be checked out.
YMMV
Hi Nick,
Your bloodwork should be sufficient to assess fibrosis by APRI (this is from the AST in the liver panel and the platelets in the complete blood count).
The new EASL guidelines have been updated to say just that.
YMMV
Hello hopey1,
The vast majority of patients – as in 95%+ are the same, or significantly better after treatment. Most patients over 50 say “I have not felt this good in 20 years”
Lucinda Porter and I did an analysis of the FDA FAERS database which covers 48,000+ side effect reports for these drugs. There is nothing unusual (or hidden).
I have about 3000 patients which is almost certainly the biggest independent sample of any doctor in the world and have seen nothing of great concern.
A significant problem with online forums is selection bias. If you look at this forum and search for posts before 2016 what you will see is hundreds of names of people you don’t see here now. They have been cured of their Hep C and moved on so their voices are lost.
Another significant problem is “post hoc ergo propter hoc” which is Latin for: “after this, therefore because of this”
. It is a logical fallacy that states “Since event Y followed event X, event Y must have been caused by event X.” – the average age of patients being treated is 55 so there is an inevitability that the diseases of ageing are going to appear before/during/after treatment.
You may find this post of mine from last year useful as it goes into much more detail:
YMMV
Hello Vedruss,
The waiting for confirmation of SVR12 can be hard.
Pretty much every relapse I’ve had has known it’s happened before the results are in so if you continue to feel ok, and possibly feel better as the pills wash out that is a very good sign.
Chances are 20:1 in your favour things will go well.
YMMV
Hi Nick,
Don’t panic. Unless you also have active Hep B it would be really unusual to run into issues below the age of 40.
It is a very anxious time waiting for details about tests and access but remember – even though you now know you have the virus, you have had it for a while already and you’re still here…
You are touching on one of the bad things about know you have hep C – the mental part. For many patients, one of the many benefits of treatment is knowing the virus is gone.
YMMV
Hello RSF,
You can read the full version of the guidelines here: http://www.journal-of-hepatology.eu/article/S0168-8278(1
31968-8/pdf which still contain mention of Daclatasvir.
The practical reality is that with branded Daklinza having a $50,000 list and branded Sovaldi having a $84,000 list that branded Epclusa with a list of $75,000 makes more sense.
In the world of generics it’s a different story. Still, it’s sad to see the change.
YMMV
Hello Ariel,
People with SVR are likely to die at the usual time ~80 of other causes.
People without SVR are likely to die earlier.
So what you can see here is that the 5 year mortality rate (chances of dying in the next 5 years) for people with current HCV is much higher than those who have SVR.
YMMV
Your viral load has fallen from 3,010,000 to 1,090 since you started treatment. The E6 says multiply by 1 followd by 6 zeros (1 million) and the E3 multiply by 1 and 3 zeros (1 thousand)
This has fallen at the expected rate.
It would be unusual to be undetected after only on week so things are progressing as expected.
YMMV
Hello Christine,
Yes it is possible. Hep C seems content to do very little for years then the wheels fall off.
The liver enzymes we measure are actually part of the “guts” of the liver cells – when these cells die we see the liver enzymes released and can measure them in the blood.
One way the body normal deals with viruses is by killing the cells that contain the virus. In some patients they have a robust response and the disease is cured, in others the response is not enough to cure, but enough to cause ongoing damage.
Some patients, often with very high viral loads just allow the virus to do its thing and, as a result, don’t have much happen for ages.
When we look at the patient demographics we can see lots of people in their 40s 50s and 60s but very few who make it past 70 – this is because Hep C tends to chop the last 10 years or so off the expected ~80 years of age average when we tend to expire of natural causes.
YMMV
Hello GF,
Nick is not on treatment yet and has no defined starting date so reaching for the good herbs and supplements beats doing nothing.
On treatment you are already on the best liver supplements ever invented for Hep C patients. Any useful supplement must have 1 or more active ingredients for which the drug-drug interactions are unknown.
Thus the advice about stopping them during treatment.
YMMV
Hi Songbird, having a world famous professor treating you probably helps!
YMMV
Hi Nick,
Drinking is an additive insult to the liver. Not drinking is a good option but low level (social type) drinking in somebody young is unlikely to have any major impact, particularly given you will get treatment at some stage in the reasonably near future.
If your e-cig was planned as a stepping stone to quitting all power to you.
Milk thistle is a herbal supplement that definitely helps. It contains silymarin and is widely used for liver conditions in the old USSR.
Coffee is actually good for your liver and has been shown to delay the onset of fibrosis so feel free to have a cup of two of Joe – there is probably a benefit in quitting this quitting!
This article from the National Library of Medicine is called “Coffee: the magical bean for liver diseases”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440772/
YMMV
Thanks countless,
Hep C is interesting in the way it impacts people. Some are very symptomatic and see dramatic changes with treatment, whereas others seem to be weathering the storm in a t-shirt and shorts.
The psychological part is neglected – it’s nice to know you and your blood are no longer infectious, and of course if exposure prone procedures are part of daily life…
YMMV
Sorry Nick,
I can’t advise about fees from your doctor. US healthcare seems a complete mystery with some patients getting treated inexpensively and others being charged an arm and a leg for tests they dont need only to not get treatment.
Worst case is you will need to see me online and sort out the prescription. That will cost $70 but you will get the correct precription with minimal grief and no judgmental BS.
There are plenty of US members who drop in from time to time and know the local landscape well
YMMV
Hi Nick,
If you can get a prescription fom your doc that is great. If not you need to ask for copies of your results. See the “What your soctor needs” section in the footer or here for details about what results are needed to prescribe…
https://fixhepc.com/what-your-doctor-needs.html
YMMV
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