Thread by @drabbyphilips

Here is something funny&sad
Yes. Its about #hepatitis C and #Ayurveda #Homeopathy #Ayush
A thread

1/
32 yr male. Routine check in 2017, found 2 have hepatitis C virus (HCV) +ve. That is, anti-HCV +ve meaning exposure to the virus & antibodies in blood.
#MedTwitter #livertwitter

2/
To confirm, PCR test 4 RNA has to be done. Which he did. The viral load was 900,000 IU/L. So he goes to a Gastroenterologist, who checks the virus genotype (it was type 2) and puts him on the fantastic direct acting antiviral Sofosbuvir+velpatasvir for 3 months. All good?
No.

3/n
He checks Google. Finds cirrhosis, liver cancer etc...gets alarmed and before completing the treatment, checks HCV at 2 months. Finds - anti HCV still +ve.
[note: anti HCV ELISA test STILL +ve]
Feels modern medicine doctor cheated him with expensive drugs.
Enter the dragon.

4/
Goes to #Ayurvedic guy. #Herbal guy says, simple. #Plant based treatment + some potent herbs will make the virus go away. So he is on 6 months intense regimen. 6 months later, he asks the man to check anti-HCV (Card test, note: CARD TEST). Anti HCV is -ve
Ayurveda 1
Science 0

5/
Patient damn happy. Applies for job in Dubai. VISA medical check up, anti HCV +ve (ELISA test). Fellow is sad. VISA rejected. Goes back to #Ayurvedic guy. He says, virus could B back. Shit happens. Lets try again. 3 months herbs. Repeat anti HCV test is -ve! (note: CARD test!)

6/
Ayurveda 2
Science 0
Patient super happy. Goes for reapplication. Just in case, this time through another agency. New VISA medical tests done. BAM! Anti HCV +ve! (ELISA test). He says, #Ayurveda guy is a fraud. A #quack!
Ayurveda 2 - 1 = 1
Science - 0
Enter the dragon II

7/
Homeopathy guy says. Its simple. V treat like with like, kill fire with fire. Patient says, do whatever, want this virus out of my body. He gives him sweety pills & spirited water. 3 months. BOOM! Anti HCV +ve (CARD test!) Homeo guy says, all good things come 2 those who wait.

8/
So he goes on highly potent sugar pills & insane powerful water for 3 more months. Repeat virus test. Damn! anti HCV -ve! Woohoo! (CARD TEST)
Ayurveda 0
Homeopathy 1
Science 0
Guy so happy. Goes 4 third VISA check up.
WTF! anti HCV+ve! (ELISA test)
Goes mad. Whole world fraud.

9/
Life comes full circle. Comes to Hepatology.
Says he wants the virus out. We discuss HCV infection.
anti HCV - only exposure, not disease
viral RNA PCR - active viral replication, needs treatment. Rechecked, -ve (initial 2 months of antivirals probably did it). No cirrhosis.

10/
Confirmatory test 4 exposure ELISA/new gen testing antibodies. Card test rapid chromatographic immunoassay, has false -ve results. Use 4 rapid screening only. Confirmation by RNA load.
Useless rechecking anti HCV. Again. & again
If RNA not detected, then treatment response+

11/11
#ayurveda, #homeopathy #naturopathy #prayer dont cure HCV infection.
Direct acting antivirals do. Early use prevents liver disease & progression, reduce risk of liver, non liver clinical events, improves survival/reduces liver cancer

Science 1
Everything else 0
BAM! Fin.