The guidelines, based on the Gilead trials suggest 8 weeks as sufficient to get the same results as 12 weeks in treatment naive, low fibrosis patients with a VL of less than 6 million

BUT

According to Gilead the SVR rate for 12 weeks Harvoni in treatment naive patients is 97%

HOWEVER

According to the VA in the states, which gave it to over 4000 veterans (10x what Gilead did) and then reported the results the real world success rate is 91.3% – ie the failure rate is 3 x higher than suggested. This raises the issue of how much we should rely on the 8 week is ok data. Here is a link to that study:

http://www.healio.com/hepatology/hepatitis-c/news/online/%7B10d8cc5c-f769-4b39-baf8-d0630d060a12%7D/harvoni-produces-high-svr-rates-in-real-world-cohort-of-veterans

So, if it was me I would be considering taking 12 weeks unless finances were such that the cost of the extra 4 was prohibitive.

One useful thing the VA study did show is that undetected at 4 weeks is a good sign and that detected at 4 weeks reduces SVR rates by 8-10%. This is part of the emerging evidence that response on treatment does have some guidance value.

8 weeks should do. 12 weeks can be viewed as 4 weeks insurance. Either is reasonable and both available.

So very happy and excited for you…..I hope you enjoyed your glass of champagne

Congrats Rohcvfighter! I’m smiling from ear to ear

Excellent explanation. Liver functions – at least the liver enzymes – are not about function. They are about damage and how much dead liver stuff is floating around in your blood.

For you that was not much at the start, and even less now. About 5% of people have normal enzymes with their HCV. These people often have high viral loads, so it probably means their immune system is not doing much about the HCV (ie killing the liver cells it has infected).

As Gaj says the normal range simply represents where you find the values for 95% of the people. 2.5% of “normal” will by definition have lower levels, 2.5% will have higher levels and while most people will be in the mid range, some will be low normal and some high normal.

That’s normal which is probably why it’s called a normal distrubution – the shape of the curve with most in the middle, and a tail out each side is called “the bell curve” for pretty obvious reasons.

Hello Murr,

Yes it will probably improve.

Cirrhosis consists of 2 things – necro-inflammation (dying liver cells being attacked by your own body) which are then replaced by fibrous tissue.

On treatment the virus is suppressed or completely killed to the driver of the inflammation goes away.

Inflammation is a generic response involving cells and extra blood and fluid – the red swelling you see around an injury that is healing on your skin is inflammation. The cardinal signs of inflammation are dolor, rubor, calor (Latin for swollen, red and hot)

Anyway if you consider balloons being expanded in a mesh that’s a bit what it’s like. Not healthy and quite squeezy in there. The liver becomes tight and rigid. If you “deflate” the balloons the liver relaxes a bit and as a result blood flow through it improves.

Hazel Heal is a patient at SVR24 who started @ 40 kPa on fibroscan and is now 9.5 kPa. This is a stellar results but most patients see progressive improvement with SVR.

This is largely academic because what you want, and what you get is this:

SVR leads to a massive reduction in all causes mortality.

I also read about the Buyers Club in the Newspaper….the rest is history