This Beatles old song somehow for me sounds suitable for hepatitis community.
Anyway, here are the answers to questions from my Bulgarian “blood comrade”.
I think that this way is more suitable than putting another reply on reply on reply.
Situation in Croatia regarding blood tests...
Q: Do you have to pay your PCR or the hospital stays?
A: No, if somebody has an insurance (and majority of people do) you don’t have to pay for PCR nor stay in hospital. You simply go to a clinic, they take your blood and few days after you can come to pick up the results. Or, if you are from another town they will send you by snail-mail.
In recent years situation has improved and now we have PCR laboratory in almost every major city.
It would be unfair to complain about it.
Some private laboratories also do PCR tests
Q: How many times per year you must apply for nucleotide, for example 2 times for these 24 months in total or..?
A: There is no rule how many times someone has to apply for nucleosides. Usually they approve for one year so if therapy works, you (your doctor) will have to apply again to extend therapy. In most of cases they approve continuation for two years. But after two years, well, you have to be very, very lucky.
And, if they somehow decide to strictly follow the rule, then you don’t have a chance. Let me quote part of the official instructions:
“In a case of HBV viral load <=10exp6 IU/ml, therapy will continue with pegilated interferon alfa-2a, while in a case of high viral load HBV DNA >10exp6 IU/ml therapy continues....”
Q: How often you should make the regular blood and liver tests? Here is every 3 months ( for interferon- every 2 weeks).
A: Testing liver enzymes and PCR depends solely on assessment of your doctor and differ from case to case. In general, when you’re beginning your therapy, testing blood can be done even on weekly basis but in most cases on monthly basis. PCR in beginning should be tested every three months and lately every six months (or every one year). As I said, it depends on many things but mostly how is patient reacting to the therapy.
And information regarding HCV drugs. Pegilated interferon can be obtained in pharmacy or bought with a valid prescription (approx 220 Euros weekly dose). Ribavirin is still not registered in Croatia and patients can get it only in a special hospital’s pharmacy via approval of a specialist.
In this area I think that we are lucky because (as far as I know) most of our doctors are very cooperative and very trained. Many of them regularly attend international meeting regarding hepatitis. They are trying to do the best with limited resources. The fact that many of new oral HBV drugs are unavailable is not their fault.
So, lack of new drugs and bureaucracy are two major problems and they are very closely interlinked. How to solve it? I have some ideas but this is nice blog and I will not use harsh words.
‘Till next time, remember, no matter how alone you may seem to yourself, stranded by the system and some others...
"And our friends are all on board
Many more of them live next door…"
