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Incase of Harvoni relapse whats next ? 8 years 3 months ago #5894

  • darbara
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:) :) Thanks for that
Treatment naive
F 3/4
Genotype 1 a & b
V/L 17 MILLION
Started Harvoni 11th Dec 2015 for 12 weeks
4 weeks VL UND
6 WEEKS ALT 32, AST 34
EOT 03/03 2016 ! UND
ALT 34, AST 26
04.04.2016 SVR 4
26.05.2016 SVR 12
16.08.2016 SVR 24

Incase of Harvoni relapse whats next ? 8 years 3 months ago #5938

Hi dabara,

Just to place things in context. Although I expect my circumstances, health and finance wise, are entirely different to yours, I was advised to do 24 weeks. Some one else used a computer program type metaphor on this forum, so here is mine. In BASIC:

10 advised to do another 12 weeks of Sof/Dac on top of the 12 weeks I am doing now.

20 paid the additional cost a week ago

30 consider it a bit of an impost coming up to Xmas and worry about the money

40 note the RAV4 is due for service, rego and insurance in Jan 2016 - bit of an impost for the New Year too.

50 worry about the money

60 consider the dollar amounts are likely to be much the same.

70 consider - would I trade my family's safety in the car for a few bucks?

80 consider would I trade my well-being (and therefore my family's financial security and not having to put up with old grumpy bum) for a few bucks either.

90 consider that drugs are paid for and on their way; go to 100

100 happy Xmas and a SVR New Year


yours



J.
GT3a 1990 Failed Inter 1998, comb in 2000. HCC 2012
Started 24/52 Sof/Dac 27th October 2015.
1. Bloods 2 October 2015: AST - 165 (20-40), ALT - 265 (5-40), GGT 189 (5-50)
2, Bloods 20 November 2015: ALT etc normal; VL 19
3. Bloods 8 January 2016: AST - 40, ALT - 59, GGT 48 VL RNA UND
4. EOT 12 April 2016 - blood tests: all is well, CT scan: okay
5. AFP 11 June 2016: 4 ref< 11
6. VL July 2016: DET
7. Oct16 start treat - June17 UND
8. Jun 18, lfts okay, platelets a bit low.
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Incase of Harvoni relapse whats next ? 8 years 3 months ago #5966

Darbara.
I am f3/f4.I am into wk 11 of Sof Dac Riba.I have elected to add another 12wks of sof dac(if it arrives in time from the Buyers Club) and another 6 wks of Riba,(which is when my Riba supply runs out,I don't want to have to buy any more,and I fall a couple of wks short of it being on the PBS).
So that will make a total of 24wks of sof dac and 18wks of riba.
According to the EASL guidelines this is overkill.According to the AASLD guidelines its what is required.From the experts I get a mishmash of opinions.I want to be in the 95% plus success cohort.The Riba hasn't been kind at times,but it hasn't clipped my wings at all.My partner often asks when is she going to get the real Miko back.
What has been my biggest encouragement is a guy up the street that is 10yrs younger than me and who has Parkinsons Disease.I often see him painfully shuffling down to the shop.I look at his agony and think “what the hell have I got to winge about,at least I have a good chance of a cure,He has none.”
It is amazing how quickly time passes.It's so little to put up with for so much to gain.
Go for the max Darbara and cut down your risk of failure to the minimum,and don't even contemplate failure..
Gen 1b 40yrs,tx naive, f3/f4.VL too high to quantify.
Started tx 12Oct.sof and riba India via greg.Dac from Mesochem.
4wk result virus not detected,all liver functions in normal ranges.
Only SE intermittent insomnia.Feel great and grateful otherwise
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Incase of Harvoni relapse whats next ? 8 years 3 months ago #5985

  • darbara
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Thanks all for the input. Merry Christmas and pray that 2016 is better than 2015
Treatment naive
F 3/4
Genotype 1 a & b
V/L 17 MILLION
Started Harvoni 11th Dec 2015 for 12 weeks
4 weeks VL UND
6 WEEKS ALT 32, AST 34
EOT 03/03 2016 ! UND
ALT 34, AST 26
04.04.2016 SVR 4
26.05.2016 SVR 12
16.08.2016 SVR 24
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Incase of Harvoni relapse whats next ? 8 years 2 days ago #14637

if fail 24 weeks of harvoni, will there be any options left
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Incase of Harvoni relapse whats next ? 8 years 2 days ago #14639

  • DrJames
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Yes, there will be options left, but chances of success are 99% so it's really really unlikely to happen to you Tweak.

You could do 12-24 weeks Asuneprevir or Simeprevir + Sofosbuvir + Daclatasvir

And who knows, maybe generic ABT-493 + ABT-530 + Sofosbuvir will be perfectovir.
YMMV
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Incase of Harvoni relapse whats next ? 7 years 7 months ago #21413

RELAPSE after four treatments!
HCV, G1b, F4, Child A-B!
Bad news! Mom has four treatments, the latter is Harvoni and she has relapsed!
First Treatment - 2000 Interferon / Ribavirin
Second Treatment - 2009 Peg Interferon / Ribavirin
Third treatment - 2015 Sovaldi / Ribavirin 24week
Fourth treatment - 2016 Harvoni 24week
Relapse!
Please give me advice what medicine to continue?
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Incase of Harvoni relapse whats next ? 7 years 7 months ago #21415

What I plan on doing; Sofosbuvir+Velpatasvir+GS9857. We have to wait for the GS9857 a few months.
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Genotype 3
VL 4,100,000
ALT 101 AST 71
Treatment Naive
Started Sof/Dac Jan 12, 2016
VL= <15 4 weeks in. AST/ALT normal.
VL=UNDETECTED 8 weeks in.
SVR4= Virus back. 3,300,000

Started generic Epclusa Sep. 23, 2017

4 weeks in <15 *Detected.
12 weeks in <15 *Not Detected.
16 weeks in <15 *Not Detected.
Finished 24 weeks treatment 3-17-18
SVR5 <15 Not Detected.
SVR 20 <15 Not Detected.
SVR 44 <15 Not Detected.

Thank you Jesus.
Thank you Dr. James
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Incase of Harvoni relapse whats next ? 7 years 7 months ago #21425

  • Gaj
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Hi Marilen,

Sorry to hear that your Mother relapsed again. As splitdog says Sofosbuvir/Velpatasvir (Epclusa) + GS-9857 is an option that looks excellent for the future although there may be others available now that would suit genotype 1b.

However, as four treatments have already failed her and noting her cirrhosis status, I would recommend that she seeks further expert advice by making an appointment for an international (Skype) consultation via GP2U Telehealth gp2u.com.au where her history and medical records can be reviewed in detail and recommendations made. Dr James Freeman usually has appointments available on Friday's but other doctors there could assist if those days don't suit. If you have further questions for GP2U their "contact us" details are here gp2u.com.au/contactus
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
:cheer: :cheer: :cheer:
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Incase of Harvoni relapse whats next ? 7 years 7 months ago #21428

edited - duplicate post

Incase of Harvoni relapse whats next ? 7 years 7 months ago #21429

Gaj wrote: Hi Marilen,

Sorry to hear that your Mother relapsed again. As splitdog says Sofosbuvir/Velpatasvir (Epclusa) + GS-9857 is an option that looks excellent for the future although there may be others available now that would suit genotype 1b.

However, as four treatments have already failed her and noting her cirrhosis status, I would recommend that she seeks further expert advice by making an appointment for an international (Skype) consultation via GP2U Telehealth gp2u.com.au where her history and medical records can be reviewed in detail and recommendations made. Dr James Freeman usually has appointments available on Friday's but other doctors there could assist if those days don't suit. If you have further questions for GP2U their "contact us" details are here gp2u.com.au/contactus


Have u started retreatment GAJ?
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Incase of Harvoni relapse whats next ? 7 years 7 months ago #21430

Marilen-Conti-facebook wrote: RELAPSE after four treatments!
HCV, G1b, F4, Child A-B!
Bad news! Mom has four treatments, the latter is Harvoni and she has relapsed!
First Treatment - 2000 Interferon / Ribavirin
Second Treatment - 2009 Peg Interferon / Ribavirin
Third treatment - 2015 Sovaldi / Ribavirin 24week
Fourth treatment - 2016 Harvoni 24week
Relapse!
Please give me advice what medicine to continue?


Probably velpatasvir and something else
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Incase of Harvoni relapse whats next ? 7 years 7 months ago #21542

  • DrJames
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RELAPSE after four treatments!
HCV, G1b, F4, Child A-B!
Bad news! Mom has four treatments, the latter is Harvoni and she has relapsed!
First Treatment - 2000 Interferon / Ribavirin
Second Treatment - 2009 Peg Interferon / Ribavirin
Third treatment - 2015 Sovaldi / Ribavirin 24week
Fourth treatment - 2016 Harvoni 24week
Relapse!
Please give me advice what medicine to continue?


Hello Marilen,

Without knowing more details this advice should be viewed as generic.

There are several options to consider.

1) Wait for better drugs - this is unlikely to help as your mum is near the end
2) Do inexpensive maintenance therapy with say Sofosbuvir + Daclatasvir like we would do with HIV while we wait for better drugs. This might well be the best option
3) Do Sof+Dac or Sof+Led or Sof+Vel PLUS Ribavirin for 24 weeks
4) Look to do a curative 3 or 4 (or even 5) drug regimen. Options are things like Sof+Dac+Simeprevir or Asunaprevir, Viekira-pak + Sofosbuvir, Zepatier + Sofosbuvir and all with ? + Ribavirin

With Child's Pugh A/B Viekira has a black box warning so it's not a good option, but like I say, this is not a discussion that can be done via online posts and your budget needs to be considered. It looks like you are getting insurance coverage so funded Zepatier + Generic Sofosbuvir might be an option. The trial the underpins that is called C-SWIFT.

www.aidsmap.com/Treatment-intensificatio...atment/page/3014995/
YMMV
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