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Viewing 15 posts - 721 through 735 (of 1,968 total)
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  • in reply to: Sof+Led vs Sof+Dac – and the winner is….. #26115
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Meg,

    With Harvoni and your profile – 1b, naive, low fibrosis, low viral load (<6 million) the evidence is that 8 weeks treatment is just as effective as 12.

    You could do 12 for insurance/reassurance, but you fit the shorter treatment profile and using it would save you $500

    Since writing this new evidence has come to light.

    http://fixhepc.com/forum/experts-corner/1576-8-weeks-versus-12-weeks-harvoni.html

    In short, 8 weeks is probably a bad choice unless you are very strapped financially, fit the profile and simply can’t afford 12.


    YMMV

    in reply to: Genotype 3/dating/pregnancy #26107
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Sexual transmission of Hep C is virtually impossible via straight sex.

    Anal sex is more risky.

    Sharing razors is a definitive risk but it’s also gross.

    The bottom line is you really need blood-blood contact so routine contact is just fine.

    Most Hep C positive mothers do not pass it on to their children, but it does happen. Presumably from blood blood contact during childbirth.

    If you treat you have a 78% chance of being undetectable by 4 weeks and cured by 12 in which case it becomes past history.


    YMMV

    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Heatherlou30,

    Jan tells me she emailed you this morning and it’s on the way today.


    YMMV

    in reply to: Any Canadians willing to share testimony? #26089
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Ricky,

    Here are some posts from patients past from Canada:

    http://fixhepc.com/component/search/?searchword=canada&searchphrase=all&Itemid=271


    YMMV

    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Ricky,

    We are relatively unique in being able to assist with getting the medication into Canada. It relates to the fact we are running a clinical trial. https://clinicaltrials.gov/ct2/show/NCT02657694

    Just type “Canada” into the search box at the top and click the button to find fellow Canadians talking about their experience.

    If you go here: http://hepcbc.ca/tag/fixhepc-club/ you will find the initial post from Hep C BC about us. A search there will turn up plenty of other “honourable mentions” with respect to patients in BC accessing meds here.

    Other people will probably mention it but we offer a delivery guarantee. If we say it can be delivered it will be, and if it can’t we wear the cost and refund patients money. We have done that, but the requirement is rare.


    YMMV

    in reply to: Can anyone help with viral load readings please? #26084
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi 2b…

    If you take the remaining portion tonight that will give you 2 days on the same mg/kg dose as a strapping 100 kg man.

    If your feeling is that’s better we have the suggestion it is dose related.

    The confirmation then comes if we increase the dose and the unwell feelings increase.

    If both those are true, then it’s reasonably suspicious that there is too much pill (or not enough you) so a small dose reduction to 45 would be worth considering.

    When we did this before (in fact I had little to do with it, the patient experimented himself) what was observed was that after a few days on a lower dose increasing back up to normal worked ok.


    YMMV

    in reply to: Can anyone help with viral load readings please? #26080
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hello Gert,

    In his blood test, virus was undetected, his doctor told him that virus could still be seen in his DNA?

    There will be something being lost in translation. Hepatitis C is an RNA virus. There is no involvement of DNA and DNA is not detected in blood it lives in the nucleus of cells.

    What is still detected at SVR is Hepatitis C antibodies.

    The question about SVR that does come up relates to “Is SVR complete removal of all Hep C RNA” and therefore complete cure. This article suggests YES:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2711258/

    This article suggests NO:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC415836/

    So maybe there remains a trace, but in practical terms, it does nothing harmful and this we know from graphs like this which show much better survival with SVR than without SVR. Because DAAs are new (3.5 years) we are making the assumption the pattern will be the same as for Interferon/Ribavirin. We don’t know that for certain, but it looks good.

    svr-mortality.png


    YMMV

    in reply to: Can anyone help with viral load readings please? #26078
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Gert,

    Have read that half the life of Ledipasvir is 47 hours,
    How many days are the substances in the blood after the treatment has ended before we can no longer measure them in the blood?

    The short answer is see this long answer http://fixhepc.com/forum/experts-corner/872-how-long-should-i-wait-after-treatment-before-getting-pregnant.html where I calculate it exactly for you…..


    YMMV

    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    That deserves a dancing man. Here’s one I prepared earlier:

    #dance


    YMMV

    in reply to: Can anyone help with viral load readings please? #26072
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hello Gert,

    The “normal range” does not exactly refer to “normal” it really refers to this statistical observation of “normal”:

    normal-distribution.png

    For pretty much any number you can measure in people – from blood pressure, to Hb, to ALT – if you measure enough people you get a curve like this, which is called a bell curve. The distribution of values is called the “normal distribution”.

    You can see that the biggest count of people having that value lies in the middle. As we more to the left (or right) we see less and less values.

    Your eyes may have glazed over in maths and statistics when the teacher talked about mean, median, and standard deviation. The mean is the average value and is in the middle of a normal distribution. The median has 1/2 the values above, and 1/2 below. It is the same as the mean in a normal distribution. The standard deviation is interesting in that 95% of all values will fall within 2 standard deviations of the mean. Standard deviation symbol is the sigma σ

    So 2 standard deviations to the left of the mean is 2.5% of people who are “a lot less than normal” and 2 standard deviations to the right of the mean are 2.5% of people who are “a lot more than normal”. These 2 bits are called “the tail”.

    You may see that the higher the standard deviation the wider the bell curve must be (to make sure 2.5% of all fall in the left and right tails).

    You may also notice that this 2.5% is an arbitrary number. It defines 5% as being outside normal. Always 5%. Even if 99% were “normal” (as in say no disease) we would still have 2.5% above and 2.5% below.

    So yes there are different testing machines but the units are standardised across countries. The range in your population simply represents the correct range to find 2.5% of people below, and 2.5% of people above. There is even a note “The following values apply to the so-called IFCC method at 37 ° C, based on the results of a major Nordic survey 5 and used by Danish laboratories” There are plenty of Hep C patients who are (untreated) in your normal range, so it is a crude tool.

    With ALT 10-70, the middle of the range is 40 so you are 10% below that and very close to the fat bit in the middle of the normal range.


    YMMV

    in reply to: Can anyone help with viral load readings please? #26066
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    I suspect what we may be seeing with the reduction of your side effects is your body getting better at removing the daclatasvir. This is a natural process called induction where you body make more garbage collectors when exposed to a certain type of garbage.

    The temporary dose reduction, then change back to normal dose is a way to see if that is the problem with minimal risk.

    If you are better on a day or two of 30 and worse back on 60 then there is some logic for trying 45.


    YMMV

    in reply to: Global Justice #26063
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Legal sound, morally bankrupt. After Nuremberg who would have thought we would write laws facilitating such genocide.

    ScreenShot2017-05-15at4.12.35pm.png

    “I did it for the shareholders” should be as valid an excuse as “I was only following orders”.

    Do the math. Multiply that number by 18/3.5. Why 18 – it is 2032 before the patents expire, and the 3.5 is how long these medications have been on the market. I get a number a little over 6 million. That number is familiar, can’t quite place where I last read it.


    YMMV

    in reply to: Can anyone help with viral load readings please? #26061
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    I think the top of the range model costs under $10!


    YMMV

    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Heather,

    If it’s from FixHepC is not a scam and you should have a tracking number so you can watch the progress as it wings your way to you.

    I can understand the “If it seems too good to be true” worry, but this is the exception that proves the rule, rather than the rule.


    YMMV

    in reply to: Can anyone help with viral load readings please? #26057
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Carol,

    2 words: Pill Cutter!

    It is a triangular holder, with a small blade on a pivot bar. Kind of like a miniature guillotine for pills. About 2 quid in Boots or Superdrug

    http://www.superdrug.com/Pillmate/Pillmate-Pillcutter/p/244155


    YMMV

Viewing 15 posts - 721 through 735 (of 1,968 total)