Dr James - FixHepC

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19 March 2016 at 11:12 am in reply to: Beaches Treatment – Harvoni (Aus PBS) #14173
Dr James
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- Guardian Angel
@fixhepc
Hi beaches, yes, you definitely deserve a slap on the wrist. You’ve mis-spelt the word!

YMMV
19 March 2016 at 11:07 am in reply to: EMA to Review New Hepatitis C Drugs for Possible Hepatitis B Rea #14171
Dr James
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- Guardian Angel
@fixhepc
A review? I thought everybody already knew that – it’s certainly part of the standard advice from ASHM here.

Anybody co-infected with Hep B should have entecavir 0.5 mg with their sofosbuvir and daclatasvir.

The entecavir costs $10-$30 a month as a generic and should be continued for at least 3 months post completion of treatment and perhaps indefinitely.

The Hep C is like weed mat – it helps keep the Hep B under control, but when you remove it the Hep B can flare, thus the entecavir.

YMMV
19 March 2016 at 9:20 am in reply to: labs and their techniques? #14165
Dr James
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- Guardian Angel
@fixhepc
Unless you are one of the rare few who had normal/near normal LFTs pre treatment in all the relapses I have seen I’ve known it’s coming a week in advance because the LFTs are off again.

A few patients scared me with elevated enzymes but came back undetected – this traced back to celebrating with alcohol.

Any of the viral load tests will pick up a relapse.

YMMV
19 March 2016 at 4:29 am in reply to: EOT Viral Load result #14155
Dr James
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- Guardian Angel
@fixhepc
Congratulations Darbara…great news

YMMV
18 March 2016 at 12:41 pm in reply to: Ariel takes the Plunge #14105
Dr James
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- Guardian Angel
@fixhepc
Hi Beaches I took 12 weeks of Sof/Led……undetected at 4 weeks and SVR4. Only side effect was insomnia and the occasional headache. As Ariel said, plenty of water helps. Good luck with your treatment. And yes it does work!!

YMMV
18 March 2016 at 10:58 am in reply to: EOT Viral Load result #14075
Dr James
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- Guardian Angel
@fixhepc
Great news Tina….so happy for you…….

YMMV
17 March 2016 at 10:34 am in reply to: Splitdog in the US #14006
Dr James
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- Guardian Angel
@fixhepc
Congratulations Splitdog….great news……

YMMV
17 March 2016 at 5:09 am in reply to: Generics Late Breaker Accepted for EASL in April #13966
Dr James
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- Guardian Angel
@fixhepc
Hi Sir,

Sadly SVR2 does not count! Close but no banana….

We expect the results to be closely looked at and thanks to Hieu they are squeaky clean with the before, during and after results clearly documented on paper.

One of the good things about HCV and generics is that it’s so clear cut: now you see it, now you don’t. The LFT results usually come in a “this is clearly before” and “this is clearly after” set of 5 or more on one page but it’s hard to argue with the HCV RNA not detected.

We can see from the forum that the safety profile/side effects are in line with expectation, and it’s not like we censor anybody.

There will be some interesting observations reported that will have global utility fighting this disease.

YMMV
17 March 2016 at 4:55 am in reply to: Splitdog in the US #13965
Dr James
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- Guardian Angel
@fixhepc
Today I got my 4 week VL test results. <15. :) My doctor here seemed to think that this means that the drugs are real, and are working.

Yes the drugs are real, and they do work.

Way back in the forum there are stories of patients who were told “It won’t work, the medication will be fake, don’t do it” but went ahead and did it anyway without fessing up and then just presented back to clinic in 1-2-3 months and got tested…..

Some of the stories about what happened next are priceless!

I am really happy for you.

YMMV
16 March 2016 at 12:20 pm in reply to: Countdown begins for the Magpie #13924
Dr James
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- Guardian Angel
@fixhepc
Congratulations Magpie….hope you are also feeling a bit better.

YMMV
16 March 2016 at 7:02 am in reply to: Squirrel Feces #13916
Dr James
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- Guardian Angel
@fixhepc
The rules governing complementary medicines are here:

https://www.tga.gov.au/publication/australian-regulatory-guidelines-complementary-medicines-argcm

Which says they need to be on the ARTG (Australian Register of Therapeutic Goods)

The ARTG is here:

https://www.ebs.tga.gov.au/

Click the “Public TGA Information” link on the left, then the “Australian Register of Therapeutic Goods”

Try as I might I can’t find “Wu Ling Zhi” listed…..

YMMV
15 March 2016 at 1:47 pm in reply to: HARVONI FATIGUE #13872
Dr James
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- Guardian Angel
@fixhepc
I think I must be one of the lucky ones…12 weeks on Sof/Led and got more energetic as time went on. Still have good energy levels since finishing treatment. Hope you all start to feel more energetic soon.

YMMV
15 March 2016 at 11:01 am in reply to: New member Intro #13848
Dr James
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- Guardian Angel
@fixhepc
Welcome CBG I have finished my treatment and am now just waiting on SVR12 results……was undetected at SVR4. You will do well on your meds and find the Forum to be very helpful, amusing and honest. I look forward to hearing you results….

Cheers
Lynne

Also welcome Mihai

YMMV
15 March 2016 at 9:21 am in reply to: CYP3A4 Inhibitors and Daclatasvir – Fruits #13845
Dr James
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- Guardian Angel
@fixhepc
Hi Gaj,

Actually it’s my fault. I knew about it and mentioned it under Taurine (as you do!)

http://fixhepc.com/forum/experts-corner/714-taurine-daclatasvir-and-treatment-failure.html#10953

….but did not add it to the fruit list. My bad.

Interesting to see that it has been independently observed!

So although Oscar Wilde is quoted

“Everything in moderation, including moderation.”

with food and DAAs I think variety and moderation are good ideas.

YMMV
15 March 2016 at 7:00 am in reply to: CYP3A4 Inhibitors and Daclatasvir – Fruits #13831
Dr James
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- Guardian Angel
@fixhepc
I’m pretty sure I posted it here but there was a vegetarian lady with a fairly large daily grape consumption getting daclatasvir side effects.

A dose reduction showed instant effect, and a grape reduction seems to have solved the issue.

So the list of no go fruits is grapefruit, grapes, pawpaw, starfruit and pomegranate

There are almost certainly other things that will cause issues.

To me the best solution is to eat a bit of everything and not too much of anything.

YMMV
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