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Post Info TOPIC: Day one Epclusa


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RE: Day one Epclusa
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I see.† Thank you.† I guess I have one of those type doctors you speak of.† But no worries,† I plan on whipping out my list of questions & jotting down each response she gives me!†



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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .

Tig


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The MELD score deals more with the mortality risk in patients with ESLD or end stage liver disease. Your test results donít indicate anything like that. If you are cirrhotic, then it progresses from compensated to decompensated, then they start calculating the MELD score, primarily for the consideration of transplantation. Without the INR you canít calculate it.†

A crude, but often used cirrhosis calculation is the AST/ALT Ratio. Given your numbers, your ratio is .76 †(AST/ALT). If that ratio is greater than 1.0, then cirrhosis is suspected. When the AST is greater than the ALT, they start looking for reasons, muscle damage, etc., but when the patient has chronic Hep C, they generally suspect the causation is liver related.

When I was diagnosed, they sent me in for a biopsy. I had three of them prior to my treatment. That was before they developed the newer blood tests and Fibroscan methods. Fibrosis estimation was the first thing they did and it seems that some doctors arenít as motivated in finding out. I think they should concentrate more on that. Itís far easier to find out now than the old biopsy days. However, I still believe the biopsy is as accurate or more so, than anything. We used to consider it the gold standard in fibrosis determination.†

jmho!†wink



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ† †Lab Ref. Ranges

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I have a question† . . I found a MELD score calculator online & I put in all the information it asked for except the INR.† Out of all of my labs, I don't have a test/result for that.† So I just put in the considered normal range for it, a 1.0.† I got a 6.† When I put in 1.1, I got 7.† My question is, if I don't have a lab result for it because my doctor didn't order it, is it safe to figure that it's probably within normal range? Idk how doctors conclude or decide about what tests to give.



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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .



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Canuck! I just now read your reply & I need to really just thank you for your kind & encouraging words.† It does ones very soul much good to see that there are others sharing in all the ups & downs of this season we're in.† Much good! A little fyi:† this is truly the only place( besides in prayer & in my own head) that I can process what I'm going through.† †And what a blessing I've found in yall!† I'm grateful for this forum, really I am.† Much of the details are a little much for the person who isn't in our boat.

At any rate, again, many thanks for your encouragement!† It helps a lot.



-- Edited by Angie Girl on Friday 20th of July 2018 12:22:17 AM

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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .



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Lol! Ya'll so silly! I didn't even realize it rhymed!† (One of my hidden talents realized haha!!)

Hey Iris! Pretty cool how we're running together neck in neck with our whips in our hands... we'll slay the dragon yet!



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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .



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hi angie with bean 17 , hahahahaahaha ,† we are all getting a kick out of that rhyme today



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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=Waiting for 3mo.VL.July=norm liverpanel.13weeks=UND



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Hi there! Good to meet you. smile

Sounds like we are neck in neck with the dragon slay, † started my beans on July 1st, so we will be finishing right around the same time! Wishing you the best,† busy woman!!

Bb, Iris



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in the silence of the woods, you will not be alone- Chief Seattle

60 years on planet, Female, diagnosed 1978 as non-a non-b, VL 8mill+, Fibro f-1f-2, Genotype 1a, treatment naÔve....UNTIL 7-01-18† !!!! started Harvoni 12 weeks. :)

4 weeks=UND, 8 weeks=UND, 12 weeks=UND (EOT= 09-23-2018)

Tig


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Yeah, Angie!! Bean 17, the time actually goes by quickly. Before you know it, youíll be going in for those final tests and youíll wonder where the time went.†smile



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ† †Lab Ref. Ranges

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Heya Angie,

YOU sound GREAT!

Working full-out all the while. Doing well in the water drinking dept. Not allowing the sides to get the better of you. Good on the water drinkin to help keep the sides down to a workable level. I am impressed! With all that water, it must be hard to slip away from busy work to take those many inevitable bathroom breaks at work - BUT - keeping the ole bod well flushed is likely helping you more than a person can realize. It's got to be done. You will be the benefactor of this extra water work.

Wish we could give you some time off work, with pay, we would if we could! Where IS that magic wand we keep looking for around here!

"Bean 17" - ha! - she's a poet, she just don't know it!

You are on the ball (getting your meds pre-ordered), and, you are on a roll - hey, that sounds dangerous to do at the same time, rolling balls! Oh, you know what I mean.

Good you are keeping a journal (of any sort is good), good you have a list of questions to take with you for the appointment at the end of the month, and what a wonderful thing to share about how you are feeling, about getting your treatment.

I think I know what you are feeling about getting this good treatment. I too felt lucky - VERY lucky, and grateful and relieved, and so, so appreciative that they helped me and allowed me to win one of the last seats in my Gilead drug trial - had i not been successful at winning this seat, i would have done sofa/riba, and only if i had failed sofa/riba, then would I have even been offered the next choice which would have been sof/dac. I was very lucky indeed to get into my Vosevi trial. I will always be grateful to them for getting me into the trial and for Gilead for their good drugs and preemo treatment.

Those were good tears to cry, and that IS a place of hope (your St. Hope). Maaaaaverlous m'dear.†smile†C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 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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Btw last nites bean was #17!



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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .



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Hey all!† Just checking in.. Sorry it's been a while but work has been keeping me busy.†

Things have been going well so far.† No sides except for when I don't drink enough water, then I get mild headaches & body aches. Other than that, sometimes I get a little tired.† But I chalk that up to the " not enough water" as well.† (That & my fast paced, never -a-break job.)† I keep a journal & have been diligent with a daily log of things, even if it's just the date & the # of magic bean I'm on.† My first lab & doctor visit is this month on the 30th.† I'm looking forward to it, I'll tell you what!!† I'm excited to see where I stand.† I'm also writing down a list of questions for her, as I've many.† They told me that I needed to call the pharmacy there 10 days before my last pill† to order the next bottle, so I did that a few days ago.

I don't think that I mentioned that the place I go is a place called St. Hope.† I was accepted by Gilead to receive my treatment at no cost, however,† i still pay for office visit.† I believe the labs during treatment are going to be at a very low cost.† †At any rate, I consider myself blessed to be receiving such an expensive & lifesaving treatment for free!† I'm not insured & like many others, I never thought I'd ever be able to get treatment.† †I cried the day I found out Gilead approved me.††

And so, my journey continues.† †Hope ya'll are faring well, I've been thinking about ya'll†



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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .



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Awesome idea! Teamwork rocks!† I'll follow the link to the new thread & copy & paste.† I just got off of work ( early day, yay!)† & logged in to a party on my thread lol! I love it!†



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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .



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Sorry Angie ... I am tromping all over YOUR thread, but, being that we started talking about NASH and research and studies and such, and then Sleestak wandered in - I have to say hi to Sleestak here, as he has no other place he lives (it would seem).

Hi sleestak! See you posted again (since your last interesting post of June 17th), you are into reading, research and study of interesting things.† Good,†you and I and some of the others here have much in common then!†biggrin

I am still hoping you will update me, i can't find any OLD posts (history) from you (outlining your personal journey),†other than your sig. line†- just your current interests? Can't you direct me to an area or a thread where we can talk more about you?

OK, Angie, back to you!†wink

Good idea Tig to start a NAFLD/Nash area - it could fill up quick with interesting stuff!†



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 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)

Tig


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I established a new section for NAFLD and NASH <here.†

Sorry but I cannot merge the last posts to that new section. If you would like to copy and paste your messages to that thread, you will then get recognition for the original post, otherwise I'll be happy to do it for you.



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ† †Lab Ref. Ranges

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Tig


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Before we get carried away with posts on NAFLD, I'm going to establish a section in our Knowledge/Info section. I think it will be a better location to discuss it. If we leave it here in Angie's New Member thread, all the information will get swallowed up by time and will be unsearchable. Please give me time to set it up before adding additional information here. I may not be able to merge these posts with the new section, but I'll try. Thanks for your patience and understanding!

This is an excellent topic and I do appreciate all the interest and contributions!



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ† †Lab Ref. Ranges

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Tig wrote:

Hi Angie,

I agree with Canuck, that kind of information would be more helpful if posted in our Knowledge/Useful Info section under a title that could be searched. I can try and set something up if you would like or you could place any further data in a new thread of your choosing. Its up to you.


†Hi

I have been exploring the possibilities of liver repair/regeneration etc. for some time and would like to contribute. This is a great topic.

I found this interesting. I have more information on exercise intensities etc. that are also informative.


The benefits of exercise training in NAFLD are well established.

When considering exercise interventions, special attention should be given to improving cardiorespiratory fitness and improving musculoskeletal strength through progressive resistance training.

Combination exercise interventions offer the potentially greatest promise by targeting both aerobic capacity and mediators of skeletal muscle that may directly alter liver health.
Myokines (signaling proteins/peptides) are released from contracted skeletal muscle into the circulation where they communicate both locally and globally with tissues and organs including the liver [50].

Myokine IL-6 directly communicates with the liver, regulating both hepatic glucose production and IL-8 expression [51,52]. Liver IL-8 expression is associated with the recruitment and activation of hepatic macrophages and stellate cells in patients with chronic liver disease, contributing to infammation and fibrosis[53] Thus, myokine IL-6 regulation of liver IL-8 expression may be a likely mechanism of exercise mediated improvements in brosis in NAFLD.

Given the available evidence, 12 weeks of moderate to vigorous intensity aerobic exercise at 46-90% of VO2max, 3 days per week should be recommended to improve hepatic fat content. Additionally, we recommend 12 weeks of resistance training on nonconsecutive days using either skeletal muscle hypertrophy or strength training protocols prescribed by the American College of Sports Medicine.

Maximizing skeletal muscle release of myokines and improving cardiorespiratory fitness may provide the one-two punch for the greatest benefits of exercise for patients with NAFLD.



-- Edited by sleestak on Monday 9th of July 2018 01:02:42 PM



-- Edited by sleestak on Monday 9th of July 2018 01:06:16 PM



-- Edited by sleestak on Monday 9th of July 2018 01:08:52 PM

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Age 54, †G1a,† †F1,† 12wks S/O 2014 - rlps†,† 12wks Har/Rib 2016 -†SVR 12 ,

Tig


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Hi Angie,

I agree with Canuck, that kind of information would be more helpful if posted in our Knowledge/Useful Info section under a title that could be searched. I can try and set something up if you would like or you could place any further data in a new thread of your choosing. Itís up to you.

I couldnít read all of it but found the use of herbal supplements interesting. Aside from their anti inflammatory effects, Iím curious to know more on their claim that they have anti viral properties. There have been so many discussions on those claims, it boggles the mind. I used Milk Thistle for years and did see it reduce my enzymes and if it kept me from going full cirrhotic, God only knows. I certainly came close, (F3) so I think the anti inflammatory action of my supplementation had to help. I donít encourage people to reach out to supplemention as a potential cure for HBV or HCV. They may help while waiting for actual anti viral therapy, but I wouldnít take them expecting any kind of cure. The article does ignite some questions though. Herbals are powerful...



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ† †Lab Ref. Ranges

Signature Line Set Up/Abbreviations† †Payment Assistance



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heehee. Watch out world - Angie's gone deep! (into good research AND with lots of energy, renewed energy it seems!) - that is very good and interesting and hopeful sounding that you are awakening differently in the AM (already!), yes, perhaps this IS going to be a continuing positive change to the good - rolling out of bed with more energy! We'll see what other good things come as well.

Re the research, maybe you can stockpile it in an area of it's very own, instead of using up all your own thread space/room - you might take a gander over at some of the other interesting informational areas we have here on the site, where a topic line is started and can be continued - you could create a informational "topic" thread just for your pet research?

Nice your start on Epclusa has gone quite smoothly for you. Keep it up!††biggrin†C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 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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There is a lot of new information being reported in the medical journals on Non-Alcohol Fatty Liver Disease and I wish to start a log in my journal to keep track of my research through the medical journals. There may be information here to help prevent the disease, and also to help reverse the disease. Other people are welcome to contribute to this " work in progress".

Avocado was the subject of some research and I was surprised that some scientists had done a review in 2015 of foods that help with NAFLD, and had this to say in the abstract: " This article provides an overview of the foods that show the most promise and their potential benefits in NAFLD/NASH, specifically; oily fish/ fish oil, coffee, nuts, tea, red wine, avocado and olive oil. Furthermore, it summarises results from animal and human trials and highlights potential areas for future research. "
(†https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588084/)

Choline is showing up in many publications to help and I came across a web site by Bill Sardi that gets right into the nuts and bolts and has abundant references back to 1934.
" Choline is not the only natural antidote

Seven natural molecules that are reported to help control fatty deposits in the liver and blood circulation are choline, inositol, betaine, methionine, rice bran IP6, garlic (allicin) and resveratrol. [Biochemistry Journal April 1951; Anticancer Research 1999; Lipids Health & Disease 2010; World Journal Hepatology April 2014] All are widely available as dietary supplements."
(†http://knowledgeofhealth.com/how-simple-dietary-supplement-can-quell-modern†-diabesity-epidemic/ )

There have been some reports of the TMAO being responsible for atheroclerosis and since it is a byproduct of choline metabolism there is the suspicion that choline could increase this malady. Resveratrol is a TMAO inhibitor and this publication states that one mechanism by which the resveratrol inhibits the TMAO is by altering the bacteria in the gut: " Resveratrol Attenuates Trimethylamine-N-Oxide (TMAO)-Induced Atherosclerosis by Regulating TMAO Synthesis and Bile Acid Metabolism via Remodeling of the Gut Microbiota."
(†https://www.ncbi.nlm.nih.gov/pubmed/27048804)

Here is a link to a report showing that the TMAO prevents atherosclerosis
(†http://www.sciencedirect.com/science/article/pii/S0021915015301921)

I reviewed several publications for evidence that resveratrol helps with NAFLD and found evidence of very mild positive effects.

I found a meta-analysis from 2013 about the effectiveness of probiotics on NAFLD:†
" CONCLUSION:
Probiotic therapies can reduce liver aminotransferases, total-cholesterol, TNF- and improve insulin resistance in NAFLD patients. Modulation of the gut microbiota represents a new treatment for NAFLD "
(†https://www.ncbi.nlm.nih.gov/pubmed/24187469)

" Found this comment of interest: " Protracted exposure to TNF- has been shown to generate oxidative/apoptotic stress that overwhelms antioxidant/antiapoptotic defenses, leading to non-alcoholic steatohepatitis (NASH). Studies in humans with NASH demonstrate that the relative risk for the development of steatohepatitis correlates with increases in TNF- or decreases in adiponectin. "

I do not remember Dr. Gundry discussing the fatty liver disease epidemic, but it looks like reducing the TNF- by reducing the lectins will also improve fatty liver disease problems.†

" Fatty liver disease (FLD) refers to a broad spectrum of conditions characterized simply by fat accumulation within hepatocytes. It affects an estimated 70% of obese individuals and 30% of the general populace. Based on MRI, prevalence is approximately 1/2 of Hispanic Americans, 1/3 of whites, and 1/4 of African Americans. It is the most common cause of chronic liver disease and subsequent cryptogenic cirrhosis, and is known to contribute to the progression of other liver diseases such as Hepatitis C and hepatocellular carcinoma. " "

CIRRHOSIS AND CIRRHOSIS REVERSAL
I did some research on cirrhosis reversal and was surprised there is evidence, in pubmed, of compounds that help with reversal of cirrhosis. One was a animal study of curcumin, and the other was a review from March, 2017 that reviewed most of the research results up to that date. I will include some excerpts that stood out to me and then links to the pubmed publications.

" Curcumin was effective in preventing and reversing cirrhosis, probably by its ability of reducing TGF-beta expression. "
(†https://www.ncbi.nlm.nih.gov/pubmed/18705752)

" In the past, liver cirrhosis was considered an irreversible phenomenon. However, many experimental data have provided evidence of the reversibility of liver fibrosis. Moreover, multiple clinical studies have also shown regression of fibrosis and reversal of cirrhosis on repeated biopsy samples. "

" In this article, we present the underlying mechanisms of fibrosis, current experimental and clinical evidence of the reversibility of liver fibrosis/cirrhosis, and new agents with therapeutic potential for liver fibrosis. "

" Chronic inflammation is the main cause of hepatic fibrogenesis and it was found to be present in the majority of chronic liver diseases such as viral hepatitis, toxic liver injury, alcoholic hepatitis, non-alcoholic steatohepatitis (NASH), and autoimmune liver diseases [5] "

" In fibrotic NASH, progression is intimately linked with insulin resistance/type 2 diabetes as well as lipotoxic hepatocyte death and intestinal dysbiosis, providing rational targets for both anti-inflammatory and antifibrotic therapy. Therapeutic strategies include reducing oxidative stress, improving insulin signaling, activating the farnesoid X receptor (e.g., with obeticholic acid), fibrosis-targeted inhibitors of hedgehog signaling, combined PPAR-/ agonists, or manipulation of altered gut microbiota using probiotics or microbiota transfer [120]. Although oxidative stress is an important cofactor in fibrosis, the use of antioxidants has proved disappointing. "
(†https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339475/)


A publication from June, 2017, World Journal of Hepatology :
" The most applied medical plants in herbal treatments were selected and their mechanism of action on liver diseases and on immun system were searched to establish the Table Table3.3. Flavonoid derivatives such as silybin, silymarin, obtained from milk-thistle [Silybum marianum (L.) Gaertn.] decreased alkaline phosphatase (completely) and gamma-glutamyl transpeptidase (partially) in CCl4 induced liver damage[17]. Moreover, it has been claimed that Silymarine containing preparations are the principal therapeutic of choice in liver diseases caused by oxidative stress. Many studies have proven that plant phyto compound Silymarin has medical applications to cure (alcoholic and non-alcoholic) fatty liver, cirrhosis, ischaemic injury, drug and chemically-induced hepatic toxicity, radiation toxicity, viral and toxic hepatitis by means of its anti-oxidative, anti-lipidperoxidative, anti-fibrotic, anti-inflammatory, liver regenerating and immunomodulating effects. Several studies have identified that continuous usage of Silymarin has significantly proved to increase the survival period of patients with alcohol-caused liver cirrhosis and primary liver cancer[18] (Figure (Figure1).1). Scientific studies also have shown that, both silybin and silymarin normalized immunoregulatory failures by restoration of the cellular thiol status, T-cell activation (CD69), together with a substantial decrease in TNF[18,19]. Effects of the selected herbal medicines on immune and liver were summarized in Figure Figure1.1. Another study demonstrated that an edible plant Artichoke (Cynara scolymus L.) prevented CCl4 and oxidative stress-induced hepatotoxicity and it protected the liver[20]. Inulin, obtained from artichoke, stimulates components of the IS[21]. The extract of the rhizome Turmeric (Curcuma longa L.), which has hepatoprotective plant, amplified both Th1 (IL-2 and IFN gamma) and Th2 (IL-10) cytokines signifying its dual immune roles. Polysaccharide fraction of this rhizome showed potent immunostimulatory action in the direction of proliferation of splenocytes cell number and IL-10 secretion. Polysaccharides of the plant extract might be causative of these proliferative and cytokine release assets in murine splenocytes. In different studies have been shown that the cytokine productions (TGF-, TNF-, GM-CSF, IL-1, IL-5, IL-6, IL-8, IL-10, IL-13, etc.) have been modulated by polysaccharide-enriched fractions[18,22-24]. Fennel (Foeniculum vulgare Mill.) and liquorice (Glycyrrhiza glabra L.) have also shown immunomodulatory and hepatoprotective effects[18,25-27]. "
(†https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474722/)

Here is a link to the table #3, mentioned in the quote above:
(†https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474722/table/T3/)

Inulin is a prebiotic found in many health formulas and there is well documented evidence that the inulin is very helpful for a variety of health problems. I will include a link to the reference in the above quote that addressed inulin, from 2005:
(†https://www.ncbi.nlm.nih.gov/pubmed/15960982)

I also took note of the emphasis on the substantial decrease in TNF by silybin and silymarin, the major active compound in milk thistle. Suppressing TNF is the main goal of a variety of biologics.



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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .



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Thanks y'all,for the imputsmile

Yes, i do take the little dear with food...& two 8 oz. glasses of water.† I do notice that i feel less tired & have more energy the more water I drink.† Overall, i feel as though for now, I'm doing well.† It's also pretty weird that i don't seem to be able to sleep past 8:00 a.m.!† You see, I'm an assistant manager of a restaurant.† †My workday hours are m-f 12:00p.m. to 10:00 p.m.

Before I began taking Epclusa, I was dragging myself out of bed!!† Not now.† And on my weekends, I'm off- I'm rolling out & getting up @ 8:00 sharp!!† Ugghh! I love sleep! Always have!† Guess my energy is seeping back in.† Haven't seen much of it in many years, so it's surprising.† †But welcome!

Oh & about that article?† It is pretty long, has lots of really interesting links as well.† I'll paste it after this post...watch out & don't get on to me if it's too long lol.

Also, the forum is very informative,† so if you have extra time, it's worth joining & giving a look- see.

I'll be keeping y'all in my thoughts!†



__________________

angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .



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Angie,

Wow, 7 days done already!†biggrin

You were wondering ... "†if any side effects were going to rear their little heads, would that have happened already? Or, are they known to happen anytime throughout treatment†"...

this is always hard to answer, cause EVERYONE is different, each of us can have a different experience! Some folk feel nothing at all (really!), others are like you after a few days or during thier first week may notice something, often mild, ... like " a stomache thing", or some have complained of feeling perhaps "things in the body" ... a bit achy/fluish, but it just varies so darn much from person to person, that it is hard to generalize. If we were forced to try to generalize, then i guess we could say that when people do feel something, we might see it happen early on during the first few weeks, then lots of folk have a lessening of whatever it is they have noticed. Hopefully you will be one of those, and with lots of water and flushing you will not feel fluey/achy for very long at all!

I would say the tendancy is for the person (if they notice any side) for them to notice it sooner (than later), and that it tends to decrease or disappear. Some generalize that sides are noticed mostly during the first few weeks, then improve. But, everyone is dif!†

Are you taking your epclusa with meal? - that may be a wise thing to do (in my book), it may not only help with absorbtion but may be easier on the gut as well.††

Many people have a hard time (at first) believing about drinking lots of water (I did - and I was not a "natural "water drinker at heart - so, as usual I learned best the hard way!) - some folk have initial sides,†then they try experimenting with drinking more water!, thus why we see some people with some sides more in the beginning than later in treatment, headaches especially (I think), sometimes body pain/fatigue -† people suddenly discover that they can prevent/control headaches with adequate hydration! But ... I do† (also) believe (as long as we are really well diluted) that any sides we may notice at first, likely do decrease as we go along, and/or we just get used to the drugs being in our system and we tolerate them doing their work.

Treat yourself as good as you can, get as much rest/good food as you can, try not to over extend yourself, especially if you are feeling "sidey", I believe what you are feeling this will pass soon for you. Good you are onto the water thing.†smile

Thanks for linking that interesting sounding thing - but we would all have to join up to read the thing you posted - is it a huge long thing?? Maybe it could just be copied and pasted instead of us all joining? Sounds interesting - i will consider joining the thing if there is no other way to read it. Thnaks. C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 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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way to go angie!!

i had my first strong dizzy spell and nausea at 2 weeks, wasn't expecting it and i was at work... it scared me a minute till the nausea went away and i could see the dizzyiness wasn't getting worse. so i came home and went to bed and sat upright and watched tv.†

i changed the time i took my pill from 3pm to 3am, very slowly backwards and never had that again. i guess i slept thru it if it did happen.

i wanted to take my pill in the day cos my Mr. got really wired and so did i at first, then i realized with my working swing shift i might need something else.

on that day i also ate cheese, and 2 other times i ate cheese i had a sick feeling†blankstareblankstareblankstare. go figure.... guess who is afraid to eat cheese now? hahahaha...me.

just make a note of any strange feelings and what you are doing or eating.†

i'm so glad you are drinking the water and focused on magic beans and the good life they bring.



__________________

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=Waiting for 3mo.VL.July=norm liverpanel.13weeks=UND



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Hello all!

biggrin†Just checking in, hope everyone is faring well.† As for me, tonight will be pill #7.† No troubling side effects to speak of, so far. Except, one thing I've noticed since yesterday, is a mild flu like feeling.† Achy feeling.. Anyhow, nothing I can't work with.† I've been overdosing on water, as advised.† Overall, it I'm doing alright.† I'm left to wonder though, if any side effects were going to rear their little heads, would that have happened already? Or, are they known to happen anytime throughout treatment?† Just curious.† Oh!† Not sure who on here has heard of Team Inspire but I ran across the following in that forum:

NAFLD and Cirrhosis Reversal- Recent Developments - nobeta1's journal - Inspire
https://www.inspire.com/nobeta1/journal/nafld-recent-developments-reported-in-the-medical-journals

I found it pretty interesting & useful, perhaps someone else may, as wellbiggrin



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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .



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water was never my favorite either. i can drink watery coffee and be so happy

but i sure did make a point to drink the gallon that tig keeps posting a picture of.

on treatment it helps to flush out the side effects and those virus bodies have to go somewhere too†wink

it sure helped me to drink that water, and even now i'm forcing myself to drink at least 3 liters a day so my immune system and all organs get flushed.

oh yea, water just gags me sometimes..... but it's part of the treatment that will save our lives



__________________

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=Waiting for 3mo.VL.July=norm liverpanel.13weeks=UND



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So, water & I are fated to become best friends,I see

It'll take some doing but I've always been good at putting my best foot forwardbleh†Here's a "virtual" cheers to all as I hold up my favorite cup in a toast!† Ugghh!no



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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .



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Hi Angie, Great to hear you are doing well. smile

Keep up with the water. As time goes on you will find it really is well worth it. Something so simple really does help. I notice sometimes when I am feeling a bit off, I think back and realise I haven't been drinking enough. Weather here of late doesn't inspire me to drink these huge amounts of water. If it was summer I am sure I would find it a lot easier, but being now in week nine of my treatment I have certainly learned to keep on sipping. I keep a large glass alongside me whenever possible, and a bottle in my bag and one in the car for when I'm out helps my remember its time to gulp some more. biggrin



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66/F Contracted Early 80's First Diagnosed Early 2000's 2017 re diagnosis and referral for treatment Gen 3a Fibroscan 8.7

Epclusa 12 weeks commenced 1 May 2018 ALT 72 AST 67

28 May 2018 4 weeks ALT 16 AST 23 ...... 23 July 2018 EOT ALT 23 AST 30 .....Oct 16 2018 SVR12 UND



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Just a quick update! Today was day 3 & still nothing major has occurred. Aside from bouts of yawning & the queasiness an hour or so after taking the little dear, all's well. I'm drinking more water, but i can do better on that score. Water & I have never been too good of friends lol . Okay, just checking in with y'all. Hope everyone had a nice 4th!!

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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .



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Yes, I was ambivalent about starting treatment, scared as heck, actually! But i decided to put my fears aside & take the leap. I don't know how long before I'll begin to notice the side effects, if I'll even have any. I've read some people don't. But last night, about an hour after i took my first pill, i did notice a slight queasiness. Oh, & i slept better than i have in quite some time! I was fearful about the fatigue & wondered how I'd fare at work but i did alright today. Anyway, it's probably too soon to tell, but I'm hopeful any side effects will be minimal. If not, that's okay too. I'm gonna stick with it because, for me, it's well worth it. I'm on my way to ridding this dark cloud!!

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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .



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Hi Angie,

Lovely to see you join us. I am also on Epclusa (week 9) We are all so lucky to be given these wonderful new DAA's for sure. My treatment is 12 weeks - 84 pills in total which came in 3 bottles of 28. I remember day one being a little intimidating but its all good. Its understandable to be a little apprehensive. I have been fortunate in not suffering much in the way of sides. Most peoples sides seem quite minor. Most important to make sure you drink plenty and rest up when you need to and I am sure the time will fly by for you. The outcome makes it a magic time which we can be very hopeful that we we finally be free of this virus, and our livers will have a chance to recover. All the best on your journey. I look forward to reading more from you over time.



__________________

66/F Contracted Early 80's First Diagnosed Early 2000's 2017 re diagnosis and referral for treatment Gen 3a Fibroscan 8.7

Epclusa 12 weeks commenced 1 May 2018 ALT 72 AST 67

28 May 2018 4 weeks ALT 16 AST 23 ...... 23 July 2018 EOT ALT 23 AST 30 .....Oct 16 2018 SVR12 UND



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Wow! Just got off work & logged in. I have to say, reading y'alls responses brought tears to my eyes. I have a couple of family members who are supportive, however, y'alls imput here has been the most I've gotten- ever!! I probably sound sappy, but I'm just being honest & i want to thank y'all for being here. That being said, i go in for my 1 month bloodwork on the 30th of this month & i plan on definitely inquiring about those tests. I'll be keeping y'all updated on my journey, & once again: thanks for neing here!

__________________

angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .

Tig


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Hi Angie,

Welcome to the forum and congratulations on finally getting started. From what I can garner from your results, things are starting out looking fairly normal, aside from the positive HCV viral load, but even that isnít extreme. Itís good to know that viral load doesnít impact the rate of success anymore. It does reduce the length of treatment sometimes.

Iím curious why your nurse and/or doctor havenít ordered an abdominal ultrasound to review the general size, shape and flow of things. It is generally a requirement before an insurance provider will even consider treatment approval. They used to be very clear on that. There are blood tests that can help determine fibrosis and that may have been completed. All you can do is ask for the results. Here in the USA, they are required by law to give you copies of all tests performed, in writing. Itís a good idea to get them and keep them, forever. You never know when they may be of value.†

Best advice is to be certain you rest, eat well, stay active (walking is good, no hard exercise) and drink a gallon of water, every single day! Not kidding... everyday! It will reduce fatigue, body and headaches that will be noticed if you donít. If you do those simple things, youíll fly through this easily and successfully!†

Now go slay that Dragon!



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ† †Lab Ref. Ranges

Signature Line Set Up/Abbreviations† †Payment Assistance



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welcome angie, i had my tumor marker and fibrosur blood test for fibrosis level done my my family doctor; so i'm thinking your nurse has connections to get them done.

i think it's called fibrotest in some countries.

welcome to the forum and i'm so happy to hear you are on treatment .yay



__________________

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=Waiting for 3mo.VL.July=norm liverpanel.13weeks=UND



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Hi Angie,

Welcome here. Glad you joined in to the site and glad you got a good treatment - Epclusa.†biggrin†Happy day one!

Your pre-treatment labs (nice you shared them), there is a lot there! Nice to know you had them all done - most of the basics they do when being thorough. From assessing your Hep A/B status to having a look at your pre-treatment bloods sugars, kidney/thyroid function, cholesterol - very good to have all these things looked at. They are hard to read in a pile like that, but from what I can glean almost all of yours are good, within normal limits. Even though you do not have the most recent pre-treatment ones available to you yet - you could still do up a signature line with what you do have (your older pre-treatment labs) .... ie, as an example of a signature line ...

... F, Age ___, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2?, 2018 to Sept 24?, 2018. ...

Your Fscore (which could be F0 through to F4) would be good info to know, the level of "fibrosis", (in part) your liver "firmness" - as determined by a "Fibroscan". Or, an Fscore and fibrosis level can also be determined by certain bloods tests (such as a Fibrotest, and others). An AFP and GGT are other common blood tests.

Abdominal ultrasounds are commonly done to assess how your liver and other organs appear, and is another good test to have done (aside from a fibroscan) and aside from various "blood test methods" to determine fibrosis levels.†

If you have not had a fibroscan done, or a Fscore number estimated for you, or have not had an abdominal U/S done, then those are things you could ask your practitioner for. Mention it just like you did here - ask if you could please have these tests done, because you see other people routinely getting them done as part of their work-up and treatment.

Your nurse practitioner likely works hand in hand with or under the control of a doctor, who will OK tests that she may not necessarily be able to order for you, without checking with the overseeing doctor first, so, just ask about tests you think you should have or would like to have.

You are off to a very good start!†biggrin†C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 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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Hey all! Thanks for having me. ‚ļ Today is my first day on Epclusa 90 day treatment. I am genotype 2b & viral load 555,000. I'm seeing a nurse practitioner at a place called St. Hope. She's pretty nice. Not sure if i should be seeing anyone else though. I see how other's have had fibro scans & other tests...tests that haven't been mentioned to me as of yet. Is this normal? Is it maybe perhaps because all the bloodwork & tests i have taken, don't warrant a liver specialist or scans & such? Wish i knew... The following are the results for all the tests & bloodwork I've had thus far. You'll notice that I've been procrastinating since last year ū£... & also, the last labs i took are not included... reason is, because my nurse practitioner hasn't shared them with me yet.. they were taken last april 27. Anyhoo, please, if anyone has any advice & wouldn't mind sharing their knowledge, I'd be most grateful!! Name Result Date Reference Range Comp. Metabolic Panel (14) (SHF) 2018-01-30 Glucose, Serum 89 65-99 BUN 15 6-24 Creatinine, Serum 0.79 0.57-1.00 eGFR If NonAfricn Am 89 >59 eGFR If Africn Am 102 >59 BUN/Creatinine Ratio 19 9-23 Sodium, Serum 139 134-144 Potassium, Serum 4.3 3.5-5.2 Chloride, Serum 104 96-106 Carbon Dioxide, Total 19 18-29 Calcium, Serum 9.3 8.7-10.2 Protein, Total, Serum 7.5 6.0-8.5 Albumin, Serum 4.3 3.5-5.5 Globulin, Total 3.2 1.5-4.5 A/G Ratio 1.3 1.2-2.2 Bilirubin, Total 0.9 0.0-1.2 Alkaline Phosphatase, S 70 39-117 AST (SGOT) 16 0-40 ALT (SGPT) 13 0-32 HAVAb+HBsAb+HBsAg+HCVAb (SHF) 2017-11-01 Hep A Ab, Total Negative Negative HBsAg Screen Negative Negative Hep B Surface Ab, Qual Reactive Hep C Virus Ab >11.0 0.0-0.9 Hemoglobin A1c (SHF) 2017-09-05 Hemoglobin A1c 5.0 4.8-5.6 TSH (SHF) 2017-09-05 TSH 4.040 0.450-4.500 CBC With Differential/Platelet (SHF) 2017-09-05 WBC 8.3 3.4-10.8 RBC 4.72 3.77-5.28 Hemoglobin 14.4 11.1-15.9 Hematocrit 43.8 34.0-46.6 MCV 93 79-97 MCH 30.5 26.6-33.0 MCHC 32.9 31.5-35.7 RDW 13.5 12.3-15.4 Platelets 253 150-379 Neutrophils 43 Lymphs 43 Monocytes 10 Eos 3 Basos 1 Immature Cells Neutrophils (Absolute) 3.6 1.4-7.0 Lymphs (Absolute) 3.5 0.7-3.1 Monocytes(Absolute) 0.8 0.1-0.9 Eos (Absolute) 0.3 0.0-0.4 Baso (Absolute) 0.0 0.0-0.2 Immature Granulocytes 0 Immature Grans (Abs) 0.0 0.0-0.1 NRBC Hematology Comments: Lipid Panel (SHF) 2017-09-05 Cholesterol, Total 206 100-199 Triglycerides 123 0-149 HDL Cholesterol 39 >39 VLDL Cholesterol Cal 25 5-40 LDL Cholesterol Calc 142 0-99 Comment: Comp. Metabolic Panel (14) (SHF) 2017-09-05 Glucose, Serum 87 65-99 BUN 16 6-24 Creatinine, Serum 0.73 0.57-1.00 eGFR If NonAfricn Am 98 >59 eGFR If Africn Am 113 >59 BUN/Creatinine Ratio 22 9-23 Sodium, Serum 139 134-144 Potassium, Serum 4.4 3.5-5.2 Chloride, Serum 103 96-106 Carbon Dioxide, Total 19 18-29 Calcium, Serum 9.5 8.7-10.2 Protein, Total, Serum 7.6 6.0-8.5 Albumin, Serum 4.3 3.5-5.5 Globulin, Total 3.3 1.5-4.5 A/G Ratio 1.3 1.2-2.2 Bilirubin, Total 0.6 0.0-1.2 Alkaline Phosphatase, S 72 39-117 AST (SGOT) 28 0-40 ALT (SGPT) 37 0-32

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angie

.†F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .

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