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Post Info TOPIC: Epclusa for gt3 - Started May 27
Tig


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RE: Epclusa for gt3 - Started May 27
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Hi JB,

I do recommend that you fast after midnight. My lab suggests 8-12 hours before the blood draw. Generally they allow you to take required medications with a sip of water, but anyone using insulin related (diabetic) medications should discuss that ahead of time. I imagine you’ll be having a liver profile, CBC and maybe a PCR at week 4. Long story short, yes, fast after midnight. When they do the blood draw, think about them sucking the life out of that Dragon, not you, lol! You’re proving to both you and that Dragon who’s in charge. This is the eviction notice, go into it with Sheriff Epclusa by your side! (Okay, corny, but you get my drift, lol)

Woohoo is right! One down and two to go. You’re on your way, Bro!



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Tig

63 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 5+ years!

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JB


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Hey guys! I've got my 4-week appointment on Monday. Today was day 27 - woo hoo - 1/3 done.

Question... I'm getting blood work done. Do I need to fast? My doctor didn't tell me anything about not eating or drinking for xx hours before. My appointment is at 8:30am, so it isn't a huge deal since that is when I'm normally starting to wake up. But, I just want to be sure. I get woozy with blood work, so...

JB

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39/M, Dx Apr 2018. GT3. Possible HCV since birth. Pre-treatment VL 653,000; ALT 201, AST 116, Fibroscan w/ Fscore of 3 w/ some fatty liver, Tx 12 weeks Epclusa ended Aug 18. MRI June showed no cirrhosis, but something on liver - possibly artifact 1.4x0.6cm. EOT VL undetected w/ ALT/AST normal. 

JB


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Thanks, Tig.

My appointment with the doctor is next Monday, the 25th. That's when I'll also get my 4-week blood work done as well.

I'll keep you posted.

JB

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39/M, Dx Apr 2018. GT3. Possible HCV since birth. Pre-treatment VL 653,000; ALT 201, AST 116, Fibroscan w/ Fscore of 3 w/ some fatty liver, Tx 12 weeks Epclusa ended Aug 18. MRI June showed no cirrhosis, but something on liver - possibly artifact 1.4x0.6cm. EOT VL undetected w/ ALT/AST normal. 

Tig


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Hi JB,

Glad the name change worked! 

Have you had the opportunity to talk about your results with your doctor? We’re not docs and aren’t able to interpret these reports. Sounds to me like they aren’t recommending anything except some repeat imaging in the near future. The radiologist will pass these results along to your liver specialist and you’ll be advised of the results and future tests. Anytime they recommend watching something in our livers, it’s important to do so. It can be nothing or something that needs to be investigated on a timely basis. This is why we all go through this stuff on a periodic basis and some of us will do it every 6 months for life. When do you get to speak with your doctor again? Let us know what his/her impression is.



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Tig

63 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 5+ years!

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JB


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I received the official report of my MRI today and thought I'd share. Still pretty nervous about things. Glad there is no cirrhosis visible, but concerned about the other things. I don't know what much of this language even means, to be honest. 

Impression
1. No MRI evidence of cirrhotic hepatic morphology or sequela of portal
hypertension. Patent portal vein.
2. Query 1.4 x 0.6 cm arterial enhancing focus within the hepatic dome
versus volume averaging with the right hemidiaphragm; if a true lesion
this would be characterized as an LR-3. Recommend attention to this
finding on follow-up imaging within 3-6 months.
3. 1.5 cm vertebral body lesion at the thoracolumbar junction, likely
T11, as above. In the absence of a known malignancy, vertebral body
hemangioma favored. Attention on follow-up recommended.


PROCEDURE: MRI ABDOMEN WITH AND WITHOUT CONTRAST

HISTORY: Abnormal liver function tests. Chronic hepatitis C.

COMPARISON: None

TECHNIQUE: Multiplanar and multisequence magnetic resonance imaging of
the abdomen was performed both prior to and following the administration
of 13cc of MultiHance contrast. There were no reported immediate
complications.

FINDINGS:
Please note examination mildly limited secondary to patient respiratory
motion.

Lung bases are predominantly clear. Heart size normal, no pericardial
effusion. GE junction unremarkable.

MRI ABDOMEN WITHOUT CONTRAST:
No significant hepatic iron or lipid deposition.

MRI ABDOMEN WITH CONTRAST:
Liver normal in size/contour and homogeneous in enhancement. No evidence
of cirrhotic morphology. 1.4 x 0.6 cm focus of apparent arterial
enhancement within the hepatic dome image 8 series 10 is not identified
on any other sequence. Specifically, no evidence of washout or
associated T2 signal abnormality.

Hepatic veins, portal vein, SMV, and splenic vein are patent.

No intra-/extrahepatic bile duct dilation. Gallbladder unremarkable. No
wall thickening or gallbladder calculi.

Spleen normal in size and without suspicious focal lesions. Bilateral
adrenal glands normal.

Pancreas demonstrates preserved precontrast T1 signal intensity and
normal enhancement. No suspicious focal pancreatic lesions or pancreatic
ductal dilation.

The kidneys enhance symmetrically. No hydronephrosis, solid enhancing
renal lesions, or perinephric fluid collections. 6 mm cyst inferior pole
left kidney image 8 series 2 and image 26 series 3.

No abdominal aortic aneurysm. No ventral abdominal hernia. No free or
organized abdominal fluid collections. No pathologically enlarged
abdominal lymph nodes.

Imaged loops of abdominal large/small bowel are nonobstructed and
without wall thickening.

1.5 x 1.5 cm T2 hyperintense enhancing focus near the thoracolumbar
junction image 6 series 5 and image 6 series 2.



__________________

39/M, Dx Apr 2018. GT3. Possible HCV since birth. Pre-treatment VL 653,000; ALT 201, AST 116, Fibroscan w/ Fscore of 3 w/ some fatty liver, Tx 12 weeks Epclusa ended Aug 18. MRI June showed no cirrhosis, but something on liver - possibly artifact 1.4x0.6cm. EOT VL undetected w/ ALT/AST normal. 



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Some labs, depending (on where you are and where the lab is located), go by 8 OR 10 ng/mL - yep, yer AFP looks really good and low to me and lamassu, and as any kind of "marker" it is a handy, good "rough" guide to use, but it is not the "be all and end all", all of you is taken into account wholistically by your docs (from ALL of your labs/tests, to your imagings, to your physical exams with them). 

These labs tho always drive me batty, complicated language they use and tests to understand, and then they always seem to be changing things up or down too! Like the cut-offs and such! Calling sometthing one thing in one country and another in an other! Using dif measurements. sigh. But luckily, AFP levels and measurements are pretty universal - and a fairly useful tool at times too! wink C.



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HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)



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Hi JB1407,

Canuck posted as I was typing this. An AFP level of less than 10 ng/mL is normal for adults. An extremely high level of AFP in your blood: greater than 500 ng/mL could be a sign of liver tumors. So your AFP is great. Once the Hep C virus is cleared we have members who have seen their kPa decrease in 6 months as liver inflammation decreases and repair begins.

 



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Male, 66, Dx 1990, GT 2a/2c. Pre-tx VL 11,500,000, ALT 10, AST 18, F3, 12.4 kPa. Rx: 12 weeks Epclusa, SOT 3/8/18, EOT 5/30/18. Week 2 VL 50, ALT 12, AST 21. EOT + 12 weeks: VL not detected, ALT 11, AST 19. EOT + 24 weeks VL not detected, ALT 9, AST 24. 8/15/19 F2 8.8 kPa.



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Hey JB,

Good to start your very own 'On Treatment" thread, altho we were talking and sharing over on the prior thread, this will be a very good place to do so too!. Great job on the sig. line as well (if I do say so myself - heehee)! Makes conversing, recalling details, so much easier.

Thanks for so dutifully getting back to us about your MRI results and keeping us updated - so far, so good I would say. Try not to fret - I think you are very lucky, not only are your getting a stellar treatment with epclusa, but it sounds like you are getting the best of care - your doc sounds very diligent and thorough. When ANYTHING turns up from the "usual" lab blips we find in HCV to other minor malfunctions (once they are discovered) of course we fret (some or a LOT, depending on the folk involved - I always labour over every lab thingy, until it gets put in it's place, and then ... I don't anymore - that's just me -  you can fret over the treatment (but that will be a waste of time - as this stuff WILL cure you and set you free from your viral infection, and your body will thank you mightly for it). And, you can fret over the MRI, until they find out it is likely just "one of those" nothing benign things appearing just to confound us. Murphies law. The wait and see tac on your doc part is telling. Wait and see is a good plan, next time around it may not be there! Maybe they will do another further kind of imaging test on you, next time, or sometime in the future (with dye) just to help further define it, should it still be there. (You didn't have any dye with this MRI, right?) Maybe they will do a dye CAT next time around, or at some point if necesaary.

I had a "thing" found, quite long after I was cured, not visualized by anyone prior, via U/S/imaging, in just showed up to make me ponder, it might have been there for some time, just no one could visualize it, in the end it turned out to be a nothing but a benign "granuloma" in my liver - an aftermath thingy resultant of my prior long-standing HCV infection and complaining liver trying to do something ineffectual about it - my cure took care of the viral infection, my body (on it's own) freed to do it's work "better" than ever (in decades), had created and then decided I also did not need the granuloma anymore - it has not been seen since, gone now as far as we know!

This may happen to you too (thingies here today, and gone tomorrow). People get weirdness thingies in their livers, hemanginomas, granulomas, etc. etc, and they are most often just gloriously benign creations that rarely cause ANY real harm to you or themsleves, and they may just sit there OR vamoose.

Don't waste any worry. Your AFP is grand, nice and low, low, low.

Good your fibroscan is showing 11.1 kPa's, keeps you firmly down in the F3 range estimate.

The blood vessel bleed in back/spine is a weirdness too, sounds unrelated and strange - I suppose they will give that more thought too. confuse Glad she will help you get checked out on that front too.

It is EX-ellent she is taking such good care of you with imagings, seeking concensus opinions and a plan to make sure you are well followed - this is a good doc in my book. Lucky you! Don't waste any worry. They would tell you when to worry, until then you are getting some mighty-fine care there! It is a GOOD thing that she looks and finds these things, then everyone knows what is there, able to check it out, and rule out any it importance it may hold. Bet ya a bundle both things turn out to be nuttin's! But now you and they will have opportunity to check things out. The extra stuff will only help to keep you busy, distracted and pre-occupied! wink  C.



-- Edited by Canuck on Friday 15th of June 2018 05:19:54 AM

__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)



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hi JB, cool that you got your own thread going now , it sure has helped me thru the tx to blog a bit and also get friendly visitors to my thread biggrin

as well as great info that helped me to get thru some days



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Gt:1a-36yrs .Started Intron-A in 96' for 2.5mo-VL still too high.taken off. Labs on 3.6.18:. A1 activity.  f3@60: fibrosur bloodtst. AFP=norm. enz=mostly norm.VL=3.9 million.sot=5.1.18>Harvoni>[8wks]: 4WEEKS=UND. Eot 6/25=L.J*13weeks=UND * 6 m =UND: CLUB ZERO.1yr.=0

JB


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Thanks, lamassu.

I've been doing well with the pill. No need for a log. I've got an alarm set on my phone every morning at 9:30. Today was day 19 and it does seem to be going quickly. My 4 week followup is just 11 days from now.

My AFP-Tumor Marker was 1.8 (ng/ML?).

For my fibroscan, it looks like my E (kPa) was an 11.1 (I took a photo of the screen/results).

My concern now is the "something" they saw on the MRI and the broken blood vessel on my back.

I'm hanging in there. Trying to keep my mind off things by staying busy.

__________________

39/M, Dx Apr 2018. GT3. Possible HCV since birth. Pre-treatment VL 653,000; ALT 201, AST 116, Fibroscan w/ Fscore of 3 w/ some fatty liver, Tx 12 weeks Epclusa ended Aug 18. MRI June showed no cirrhosis, but something on liver - possibly artifact 1.4x0.6cm. EOT VL undetected w/ ALT/AST normal. 



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Hi JB1407,

Welcome to the forum! Do you have the kPa value from your FibroScan? A kPa over 12.5 usually indicates some cirrhosis. Also it is usual for your hepatologist to order an AFB Tumour marker blood test. Knowing those results might ease your concerns. The three months of Epclusa will pass quickly don't be surprised if you have some fatigue as a side effect. I sure did but my starting viral load was much higher and older patients seem to be more prone to fatigue. Your viral load is on the low side; anything over 800,000 IU/mL is usually considered high. I was over 11,000,000 before treatment and two weeks of Epclusa reduced my viral load to 50 IU/mL.

Remember to take your daily Epclusa with a meal (helps absorption rate) same time each day (I chose dinner), keep a log so you are certain you do not skip a pill and drink a full gallon of water a day. The full gallon of water is key to minimizing side effects. I filled a gallon jug in the morning and made sure it was empty by 10 PM. Best wishes for undetectable viral load at end of treatment!



-- Edited by lamassu on Thursday 14th of June 2018 02:56:15 PM

__________________

Male, 66, Dx 1990, GT 2a/2c. Pre-tx VL 11,500,000, ALT 10, AST 18, F3, 12.4 kPa. Rx: 12 weeks Epclusa, SOT 3/8/18, EOT 5/30/18. Week 2 VL 50, ALT 12, AST 21. EOT + 12 weeks: VL not detected, ALT 11, AST 19. EOT + 24 weeks VL not detected, ALT 9, AST 24. 8/15/19 F2 8.8 kPa.

JB


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Hello friends! I thought I'd also go ahead and create my own thread since I am no longer "alone and scared" (well maybe just a little scared still). 

I started the Epclusa on May 27 for gt3. At the time, I wasn't sure what my viral load was, but I just asked my doctor and she said it was 653,000 (seems pretty low, right?). 

So far so good on the meds. No major side effects, but the occasional headache. Hopefully I continue down this seamless path. 

I had an MRI on Tuesday. They wanted to do that to make sure I didn't have any cirrhosis due to the genotype and because my fibroscan came in around F3/F4. The doctor called today and sort of freaked me out a little. The good news is that they didn't see any cirrhosis on the liver. She also mentioned that no fatty liver was detected (initially they said "some" fatty liver). Also good news. Now, the part that she doesn't seem too worried about right now. They said there was something on the liver 1.4cm x 0.6cm. She said that in the report they were waffling with even calling it a lesion because she said it could be just a random artifact. She wants to review with some other members on her team that are radiology experts, I guess, and said that they'd likely want to do another MRI in 3-6 months. 

Another odd thing they discovered was a broken blood vessel on my spine - or near my spine. I'm not sure what the deal is with that. She said she's not an expert in the spine area, but may want to see a specialist. Great. Just another thing to worry about. 



__________________

39/M, Dx Apr 2018. GT3. Possible HCV since birth. Pre-treatment VL 653,000; ALT 201, AST 116, Fibroscan w/ Fscore of 3 w/ some fatty liver, Tx 12 weeks Epclusa ended Aug 18. MRI June showed no cirrhosis, but something on liver - possibly artifact 1.4x0.6cm. EOT VL undetected w/ ALT/AST normal. 

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