There is no suggestion in any of the guidelines from the experts at AASLD or EASL to “wait for virus level to fluctuate to lowest level” before starting.

Viral load makes no difference to treatment success so the best time to start is today. The next best time is tomorrow.

Hello HCV2B,

Thanks for your patience. Sorry things have taken a little longer than usual. For an order like yours, that was made on the 13th, it would usually be with you on the 27th – about 2 weeks. Sometimes it does take longer.

We understand the waiting is stressful, but as one patient once said, I’m not really surprised this can take a while, I’m more surprised that this works at all.

DHL has half a dozen arrival hubs in the USA and some are less problematic than others. Unfortunately, a new hire at the FDA decided that rules is rules and 3 shipments were confiscated in the Cincinnati processing centre. Imports into the USA fall under the discretionary powers of the FDA. With the right words in the right places that discretion has been exercised and the medications have been cleared for delivery.

DHL can’t deliver them right this second because they are physically with the FDA but they will drop back into the delivery system shortly, they will arrive, you’ll take them, and chances are you’ll be cured.

Hello HCV2B,

If you were in Australia and I prescribed you Epclusa all I could prescribe would be 12 weeks, regardless of genotype, regardless of cirrhosis.

If you have a look at the EASL guidelines here: https://fixhepc.com/genotype-specific-hepc-treaments.html

You will notice that the only patients where 24 weeks is suggested are GT3 cirrhotic patients.

You have GT2. Knock on wood it’s either the easiest or second easiest (after GT1b) to treat.

12 weeks should be fine.

Anything more than this is probably not required, but some patients elect to take out a little insurance.

Cure rates look something like this:

8 weeks 90%
12 weeks 95% (+5%)
16 weeks 97% (+2%)
20 weeks 98% (+1%)
24 weeks 98.5% (+0.5%)

So what you should notice is that the +5% for the 4 extra weeks after 8 weeks is probably worth it, but that each extra bit of duration delivers less and less extra cure. You might get something like 3.5% extra cure rate for double the duration (and cost).

For a government, this does not make sense. For some patients it does and if the treatment is not causing side effects the only real harm done with overtreatment is to the hip pocket.

With the stupid captcha code can you explain how you login and post and where it appears?

If you just go to https://fixhepc.com/forum and login from there it does not appear for me.

Hello HCV2B, Jan will have been in touch.

You’re the second person we’ve seen get an FDA letter, which is a new thing.

So too is the notion of charging a tax. We see this randomly in the UK, but in the USA it’s only just started to happen.

Hello HCV2B,

Don’t panic, we are good at getting things unstuck. It’s best to talk to Jan or Andrew directly via email as they will know exactly where things are at. It is midday Sunday here so they will be on deck in 24 hours.

What better gift for Thanksgiving.

Great to see it running according to plan.

Provided you have 0.5 of a neutrophil we are happy.

Hi Barry,

If they guy is Australian with a Medicare card then what we want for GT1 retreatment is Viekira + Sofosbuvir or for GT3 Zepatier + Sofosbuvir. For GT2 12 weeks Epclusa is all we can get on the PBS but for retreatment, you could add a bit of generic Sof+Dac or Sof+Vel to extend that.