i-base Pocket size Pocket size Hepatitis C for people with HIV

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1 Pocket sze Pocket sze -base Hepatts C for people wth HIV March 2017

2 Ths leaflet s about confecton wth both hepatts C (HCV) and HIV. Web lnks are for more nformaton.

3 HIV s now easy to treat and HCV can be cured (wth DAAs). The meds work very well wth low rsk of sde effects. HIV meds are now wdely avalable n every country. Gettng DAAs s more dffcult, even n the UK. DAA = drect actng antvral. -base.nfo/daas

4 Fndng a doctor Fndng out you have HCV can be dffcult, especally f you have been HIV postve for many years. Or perhaps you may have known about HCV for a long tme and are only now thnkng about treatment. Whatever your stuaton, many people have both nfectons. HCV s usually a slow nfecton. -base.nfo/hepc

5 DAAs cure HCV n more than 95% of people - from 1 or 2 plls a day, usually for only 12 weeks. You wll need a doctor that understands confecton. If you have dfferent doctors for HIV and HCV, they need to work wth each other.

6 Dagnosng HCV Two tests are needed: 1. An HCV antbody test. A postve antbody result means that you ether have HCV now or that you had t before and cleared t. A negatve result mght also mean that you caught HCV recently. Ths test wll not detect early HCV because t can take 6-24 weeks after nfecton for HCV antbodes to develop. Also, f your CD4 count s less than 200, you may not make antbodes to HCV.

7 2. An HCV vral load (RNA) test wll confrm or rule out actve nfecton. HCV vral load tests look for the vrus n the same way as HIV vral load tests. If you have detectable HCV vral load, t means that you have current HCV nfecton. If your HCV vral load s undetectable, a second test should be done sx months later. Two undetectable vral load results show that your mmune system has cleared HCV. -base.nfo/gudes/hepc/testng

8 Other tests for your HCV care These other tests are mportant for montng your health HCV vral load (RNA) HCV genotype (mportant for treatment optons). Hep B and hep A. Complete blood count (CBC) and blood clottng tme. Lver enzyme tests (ALT AST, albumn and GGT) Fbroscan or alternatve non-nvasve test.

9 Checkng your lver In the UK, non-nvasve tests lke a FbroScan are used to measure lver damage. Ths has replaced the need for lver bopsy n most cases. watch?v=l_e4zgmkooa In ths YouTube vdeo, Dr Sanjay Baghan from the Royal Free Hosptal n London shows how a Fbroscan works.

10 New HCV drugs Snce 2014, many drect actng antvrals (DAAs) have been approved and others are n development. DAAs have very hgh cure rates from short-course oral treatment and few sde effects. The drugs are not expensve to make, but the prce charged to the NHS s very hgh. Current DDAs nclude: sofosbuvr, ledpasvr, smeprevr, daclatasvr, ombtasvr, partaprevr/r, dasabuvr, elbasvr, grazoprevr and velapatasvr. -base.nfo/daas

11 All hepc gudelnes now recommend DAAs, sometmes wth rbavrn, but they need to be chosen carefully. Older HCV drugs For many years HCV was treated wth pegylated nterferon (PEG-IFN) plus rbavrn (RBV). These drugs are less effectve, especally aganst some HCV genotypes. They nvolve longer treatment wth more dffcult sde effects. In the UK, some people wll stll be offered PEG-IFN and RBV.

12 Gettng new HCV meds n the UK DAAs are avalable free on the NHS, but they may not always be avalable to everyone who has HCV. Only people wth the most advanced lver dsease are gettng prorty to DAAs. Retreatment s not avalable, for example, f you become renfected. Some people are buyng generc DAAs onlne (at much lower prces) to get better and faster treatment.

13 Buyng new HCV meds onlne Anyone n the UK can buy medcnes for personal use from an onlne pharmacy. Onlne generc DAAs cost about 1200 (vs. more than 30,000 pad by the NHS). In some countres generc DAAs cost less than 500. Your HIV doctor should be able to advse you on whch meds would work for you and on extra montorng tests. -base.nfo/qa/10734 fxhepc.com

14 Access to DAAs Gettng access to DAAs for everyone needs the NHS to negotate much cheaper prces and the drug companes to aggree to ths. Although HCV progresses slowly n many people, everyone should have the chance to be cured. Get nvolved n mprovng access. Wrte to your MP and Hosptal Trust. Jon a communty campagn. Generc versons of these meds only cost less than $500 to manufacture.

15 More nfo Ths leaflet s shortened from a much longer booklet on confecton. -base.nfo/gudes/hepc The full booklet ncludes more nformaton about transmsson, dagnoss, treatment and support about lvng wth HCV confecton. Informaton s all onlne or we can post you a free prnt copy. -base.nfo/order -Base, 107 The Maltngs, London, SE1 3LJ.

16 More pages >>> New HCV meds can cure nearly everyone... They should be avalable to everyone wth HCV.