AASLD Patient resources:

Patient Information

Yes that is my concern. It really has the potential of throwing open the gate to many unsuspecting.

I believe the politicians are just now awakening to the potential ramifications. The historic changes are interesting.

From, "Well I had fun but did not shoot anything, and I don't have tattoos so ..."

That is pretty much the way it was. Blood transfusions were exceptions but that is about it.

So say IVDU is #1

Tattoos #2

Transfusions #3

Used to be I can rule out Hep C because 1, 2 and 3 are all NA.

Man you add folks running candy up their nose during the Disco Days alone and you have added a LOT of people to the potential category.

Note to reader: Mention of "Disco Days" in no way implies I ever understood that crap. True an occasional Bee Gees song at just the right moment often landed you in the backseat but that is about the only fond memory of the time I have.

All the more reason for folks to get tested. The cure is here, let's get rid of this Dragon before he stalks our kids.

JimmyK

No, it has been referenced before but you don't see it mentioned in a lot of articles. There is evidence that the straw or dollar bill used can get contaminated with blood from the nasal passages. Lots of bloody noses from snorting dope. Meth and cocaine seriously irritate mucosa. Seems entirely plausible when you think about it.

Thanks Tig.

It may be that I missed it before, but Intranasal illicit drug use. Is that a new addition to risk factors?

JimmyK

A summary of current recommendations for care. 

HCV - AASLD Testing and Linkage to Care 

Time to bump this! New members seeking information should take time to familiarize yourselves with the latest guidelines on treatment. These updates were made in Oct. 2016. The next year will prove interesting in pangenotypic drugs and even shorter courses of care.

Initial Treatment Guidelines 

SF,

Well stated my friend! The advances in care in just 5 years has been nothing less than stunning to observe. We have seen some long term effects arise from the old SOC's and I'm happy to see the Interferon protocols disappearing. Many of us will have to deal with them for awhile or forever, who knows. It's my hope that with each new protocol the possibility of treatment/post Tx side effects will lessen in both chance and severity. Certainly the new DAA's are showing that to be true.

You correctly stated that because of the Pioneers, our road to the future has been extended and enhanced. Each new drug has been proven by years of trials and research. The only way that happens is through their willingness to find a cure. Because of each member here and elsewhere, we are finally achieving that goal...

Thank you as well Tig for posting this information. It can all still make your head spin especially when they flip flop back and forth with some guidelines with regards to length of treatment however it seems they are starting to all get their heads together and start to agree more.

I know that in the past and even during treatment I had read that I should be taking 24 weeks or 12 weeks of Harvoni with Riba. These even in this small time since the beginning of this year have finally started to settle down to a common denominator. I know I sort of wished I had taken 24 weeks of Harvoni instead of just 12 although it has been proven, 12 was enough of a magic number to kill the dragon. SVR 12 say's that and SVR 24 should totally put it to bed once and for all.

I still know there will be much data that will be revealed as time goes on since we are the pioneers for these drugs and short/med/long term effects will take years to establish as the information and feed back from the patients come in. It has already. That being said, I never thought I would be cured and here I am, cured. I am sure there is a lot more ahead down the road as a result of having this for 45 years but as long as there is a road, I believe that was one thing that was extended for some unknown length of time. Let them learn from us, as they did from those who came before us to make it better, faster and eradicate this from the face of the earth.

It is not a bad legacy to leave behind.

SF

Thanks Tig. I like to read everything I can!

I just updated the AASLD initial treatment guidelines. Thought you would like the newest update.

AASLD TX GUIDELINES  (Same link as below)

I was just about to post that link and saw you beat me to it Tig. :) I will be taking some of this info printed out into my doc's office next week.  Here's a quote from that site I found interesting:

"It is important to keep in mind that FDA only will approve drugs that have gone through rigorous testing," said IAS-USA panel co-chair Michael Saag from the University of Alabama at Birmingham. "We cannot run a Phase 3 trial on every possible [drug] combination or every possible patient population. The website allows experts in the field to look at the emerging data and craft what we feel the evidence supports, [which] may fall short of what is specifically in an FDA-approved package insert." 

"For genotype 1 patients who cannot take interferon, the panel recommends sofosbuvir plus the HCV protease inhibitor simeprevir (Olysio), with or without ribavirin, again for 12 weeks. This off-label regimen has not been through full Phase 3 testing, but performed very well in the Phase 2 COSMOS trial. 
An alternative for this group is sofosbuvir plus ribavirin for 24 weeks, though the panel noted that it is not as effective as sofosbuvir plus simeprevir, especially for patients with liver cirrhosis." 

"For patients infected with genotype 1a HCV, baseline resistance testing for the Q80K polymorphism may be considered. However, in contrast to using simeprevir to treat a genotype 1a HCV patient with PEG/RBV when the mutation markedly alters the probability of an SVR, the finding of the Q80K polymorphism does not preclude treatment with simeprevir and sofosbuvir, because the SVR rate was high in patients with genotype 1a/Q80K infection (SVR12 rate for cohort 1 was 86% [24 of 28 patients]; SVR4 rate for cohort 2 was 90% [10 of 11 patients]). To date, virologic failure has not been observed in patients in either cohort infected with HCV genotype 1b and with HCV genotype 1a in the absence of the Q80K polymorphism. Thus Q80K testing can be considered but is not strongly recommended." 

I came across this report and found it interesting. Is fairly recent and discusses current treatment recommendations for all genotypes. I thought you might find it informative as well.

Tig

INITIAL TREATMENT OF HCV INFECTION IN PATIENTS STARTING TREATMENT

Updated 09/16