Splitdog,
you should consider data from this small Phase 2 trial (sof/vel/riba @ 24 weeks for retreatment)
www.hcv-trials.com/showStudy.asp?Study=112
www.catie.ca/en/treatmentupdate/treatmen...a-ribavirin-retreatm
www.natap.org/2016/EASL/EASL_11.htm
www.natap.org/2016/EASL/EASL_56.htm
Another news is Velpatasvir may get available in India ~ March 2017 (or earlier) as the local Indian trials of generic sof/vel end, unless the approval is expedited.
The sof/vel/vox trial for NS5A-experienced people is going to end in Jan 2017 (
www.smartpatients.com/trials/NCT02607735) => sof/vel/vox may get to be FDA-approved in July 2017. Generic availability - 6+ months from that moment in India, unless local Indian trials requirement is waived there (it might happen because nothing else is better for retreatment) or 0+ months elsewhere (Bangladesh for example).
The main question in your case would be - how effective sof/vel/vox would be for retreatment of a sof/vel/riba & sof/dac combined failure for a fibrosis state. It may get answered in Jan 2017.
However, you should consider sof/vel/riba @ 24wks if your liver got worse. No more trial results for now.
EDIT: Please, note that people on this trial had been treated with suboptimal doses of velpatasvir before relapsing (25 and 50mg vs 100 mg). The natap publication includes more details, but there is a typo there - it is 50 mg that the dose of velpatasvir that 59% of prior relapsers had been treated with was, not 100 mg. The results may differ for those previously treated with the optimal 100 mg dose of velpatasvir or patients with an advanced liver disease.
Also, the problem is dac gives y93h resistance in 90% of variants after a relapse.
aac.asm.org/content/58/9/5155.full
Velpatasvir is generally weak against Y93H in gen 3 viruses. However, 14 of 15 people with Y93H mutation were cured with sof+vel+vox, 9 of 11 (13 people with NS5A RAVs in total) people with gen 3 and y93h were cured with sof+vel+riba @ 24wks.
Both were phase 2 trials, so they do not provide statistically significant information. You may or may not get cured with sof + vel + ribavirin (for 6 months) now, if treated. More reliable statistical data on retreatment comes in 2017.
Gen 1b
VL pre treatment 29000 ME/ml
AST 32 ALT 94, F0
Started treatment 13 January 2017
Generic sofosbuvir/velpatasvir (Incepta)
VL 9 days into treatment <300 (undetected)
AST 13.8 ALT 22
Side effects: mild dehydration, not a problem at all if I drink water at night, nothing to worry about
Diet and gastric ph are very important with velpatasvir. One must think what and when to eat to keep gastric pH low. Side effects disappeared 2 weeks after, unless I ate anything < 4hrs before the pill. SVR60.