Hi G,

That all looks in line with expectations.

Your platelets have not changed and we don’t really expect them to. Anything over 50 is enough so your good there. Your liver function has improved a bit which can be seen in the reduction in the INR (clotting time – needs liver made proteins to work properly) and fall in the ALT enzyme back into the normal range.

Things are on track. You’re taking the best medication available for Hep C re-treatment namely Sofosbuvir and Maviret which are the strongest NS5B, NS5A and NS3/4A inhibitors in existence.

How are you feeling?

Hello Sherif,

Ledifos is a generic Harvoni made by Hetero who are one of the better generic manufacturers.

Like Harvoni it is only suitable for genotypes 1, 4, 5 and 6. It does not work well on genotypes 2 and 3.

So, while it is an effective medication, and with F2-F3 a 12 week treatment course will have about a 95% cure rate you do need to know your genotype. Do you know it?

Online pharmacies vary from outright scams, through to people supplying fake products, through to totally honest merchants. It would be a good idea to check your viral load 4 weeks into treatment – there is an 80% chance this will be undetected at this stage.

Best of luck with the treatment and keep us posted here about how things go!

Hi G,

If you could post the results as they come to hand that would be great.

The depression with Viekira towards the end was almost certainly a ribavirin side effect so, fingers and toes crossed, it will probably NOT happen this time around.

Hypo = less = cyst
Hper = more = cancer

Hypo is good.

It’s great to hear you can feel the difference already. These medications are good and you are taking a good one. It should all be OK, but here’s the thing. On the first round of treatment 5% of people fail. That’s sad, but at FixHepC we run by the mantra of the US Marine Corps – No man (or woman) left behind.

I have nearly 4000 patients. About 200 failed the first round. A few died, but everyone else we got cured the second (or in a few cases 3rd) time around.

It will be ok.

PS: The hypodensity in the liver is most likely a cyst, particularly with the AFP of 20 which, although it is > 11 is completely normal for cirrhosis. 200-2000 is normal for HCC so you are much closer 2x to normal on the AFP than cancer 10x +

With cirrhosis, there is a 3% per year risk of HCC (aka liver cancer) so you will need several years of follow up with AFP and Ultrasound once you are cured, but at the moment it looks normal and unworrying.

Hi Peter,

If, before treatment you had high values for your ALT and AST liver enzymes on you CMP then “proving” cure can really be as simple as repeating just the CMP and checking that your ALT and AST are back in the normal range – if they are down we know that there is no liver damage happening, and therefore there is no active Hep C.

You can get a viral load for about $150 (and under $100 in say Texas) using any of the providers listed here:

https://fixhepc.com/link2labs – and all but one of these labs will do it WITHOUT a doctors order and give the results straight back to you. Even for routine things like a CMP they are cheaper and use Quest and/or LabCorp collection centres. For example a CMP from https://www.walkinlab.com/category is $28 and a CBC + CMP is $44 so 1/2 the $88 you’ve been quoted…

Hello Pacific,

The itching is almost certainly a mild drug allergy. You may find some over the counter antihistamine, probably taken 1 hour before the Maviret helps a bit. Short of changing the medication this is likely to continue through the entire treatment, but stop the day after your last tablet.

How long are you scheduled for? Ideally we would like 16 weeks Maviret for someone F4 with GT3.

Although we call the virus Hepatitis C it is known to infect many other organs including the brain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840160/

My first bit of advice would be to tell your doctor exactly what you are feeling so they can arrange any tests they think you should have.

My second bit of advice would be to treat the Hepatitis C. There is no useful purpose served by delaying treatment because

1. the drug pipeline has finished so there is nothing better in development meaning
2. you will be treated with drugs that are currently available and
3. it is quite likely that some, perhaps all, or your current medical issues will disappear with treatment.