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Treatment options for patients who have failed 6 years 9 months ago #12195

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Gaj directed my attention to this. It is a nice overview.

onlinelibrary.wiley.com/doi/10.1002/cld.532/full
YMMV
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Treatment options for patients who have failed 6 years 9 months ago #12313

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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Treatment options for patients who have failed 6 years 7 months ago #14748

More data on retreatment after failing with DAA's, theres hope yet.

www.hepmag.com/article/fail-hepatitis-c-...lent-subsequent-shot
Two time relapser.

SVR 4 achieved 12/16 at last
SVR 12 achieved 22/02/2017 The Bastard has been defeated :):):)

GT 3 - about 28 yrs with HCV
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Last edit: by Paul-Jarman-facebook.

Treatment options for patients who have failed 6 years 7 months ago #14772

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Looking good for us G3's there, for a change! so far at least. Not many far enough through to really say yet but still, does look good.
Genotype 3 30 years, 2x treatment interferon/ribavirin non responder. Cirrhosis 17 years. Fibroscan, decompensating, 40 down to 22 by 29/3/16- now down to 6.5, normal, no cirrhosis. Started Buyers Club Sof/Dac 14 Nov 15. SVR 12 29/0716
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Treatment options for patients who have failed 6 years 7 months ago #14773

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All great
Have emailed to self all links just in case
So much good oil in this forum so reassuring xxx
Gen 1a
Peg/inf/riba 2012(!) stop @ Wk 43 potassium low +issues (rlps week 4 post tx, VL120,000) scnds eg. adenomas.
pre sof/led VL 240,000 Fibsc F0
Day 25 <30
Day 32 UND
Week 10 UND
EOT UND ALT11AST17GGT19
SVR4 UND ALT10 AST16 GGT13
SVR8 UND ALT <9 AST16 GGT15
SVR12 UND ALT14 AST19 GGT12 Bili 5
EOT +18 ALT13 AST20 GGT9 Bili 5
EOT +21 ALT11AST15
Cured SVR12
Dysplasia Adenomas RemvdAug '16
SVR24 UND ALT11AST16
ColonoscopyClear Nov17
LumpectomyClear ‘18
LithotripsyCytoscopyBiopsy 4/18
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Treatment options for patients who have failed 6 years 6 months ago #17150

Hi
1a F4 compensated cirrhosis.
24 weeks treatment Harvoni/Ribavirine
Relapse.

What to do next?

Thanks

Jon
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Last edit: by nobreferreira.

Treatment options for patients who have failed 6 years 6 months ago #17167

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Sorry to hear that.

fixhepc.com/forum/relapse-corner/858-exp...-on-retreatment.html

Would be a good place to start.

The exact re-treatment options will depend on where you are and what's available.

Sofosbuvir + Davlatasvir for 24 weeks plus an NS3/4 inhibitor like Simeprevir or Asunaprevir would be a good option.
YMMV
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Last edit: by DrJames.

Treatment options for patients who have failed 6 years 6 months ago #17273

nobreferreira wrote: Hi
1a F4 compensated cirrhosis.
24 weeks treatment Harvoni/Ribavirine
Relapse.

What to do next?

Thanks

Jon


You have < 25 for vl. Retest your vl soon?
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Treatment options for patients who have failed 6 years 5 months ago #17521

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In Australia another PBAC is approaching
This is the citation from the HepOrg (a govt funded org) re new meds for recommendation:

"Dear ****

The Pharmaceautical Benefits Advisory Committee (PBAC) will consider a new drug combination for hepatitis C treatment at its meeting in July.
The new combination medicine being considered is grazoprevir + elbasvir (Zepatier®), a once-daily, single tablet regimen for the treatment of HCV genotypes 1,3,4 and 6. Used with or without ribavirin, the treatment is highly effective in people with compensated cirrhosis."

I'm writing a letter to recommend this be approved by the PBAC. In Australia the PBAC can move slowly so lobbying is important
Thankyou for your interest and remember there's an election at the same time as this scheduled meet.

Ariel
Gen 1a
Peg/inf/riba 2012(!) stop @ Wk 43 potassium low +issues (rlps week 4 post tx, VL120,000) scnds eg. adenomas.
pre sof/led VL 240,000 Fibsc F0
Day 25 <30
Day 32 UND
Week 10 UND
EOT UND ALT11AST17GGT19
SVR4 UND ALT10 AST16 GGT13
SVR8 UND ALT <9 AST16 GGT15
SVR12 UND ALT14 AST19 GGT12 Bili 5
EOT +18 ALT13 AST20 GGT9 Bili 5
EOT +21 ALT11AST15
Cured SVR12
Dysplasia Adenomas RemvdAug '16
SVR24 UND ALT11AST16
ColonoscopyClear Nov17
LumpectomyClear ‘18
LithotripsyCytoscopyBiopsy 4/18
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Last edit: by Ariel.

Treatment options for patients who have failed 6 years 3 months ago #20596

Just thought I'd share-- I asked about an HCV RNA NS5a resistance test and it is over $900 USD. They said they could do a cash price of $748. This test is specialized, not many labs can do it, and it is not cheap! :unsure:
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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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Treatment options for patients who have failed 6 years 3 months ago #20597

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Considering that is roughly the price for an entire 12 week course of Sof/Vel (Sofosvel) that's a tough choice. 12 weeks of medication or a test which may or may not inform ones choice as to which medication to use.

Perhaps this is a simplistic suggestion, or a course of action you have already taken.... If I were in your shoes, I'd be booking an appointment with Dr James to help sort out the dilemma.

Whatever your decision, you now have options and good ones Splitdog. :+1:
Failed Interferon 96', G1a, VL = 9 - 5.5 Million, F3/A3, AST 111, ALT 190, Generic DAA treatment Sof/Led (Mylan - India MYHEP LVIR) - 8 June, 2016
2 Week Results 20 June, 2016 AST 19, ALT 32
4 Week Results 06 July, 2016 AST 22, ALT 30, VL = 35
6 Week Results 20, July 2016 VL only = HCV RNA Detected, Non-Quantifiable <15
8 Week Results 04 August 2016, Labs, LFTs Normal, VL = UND
12 Week Results 31 August, 2016 LFTs Normal, VL = UND
EOT + 4 Weeks, LFTs Normal, VL = UND, "SVR4"
SVR12, 21 Nov 2016. CURED!!!
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Last edit: by fitz.

Treatment options for patients who have failed 6 years 3 months ago #20598

Yes, I cannot justify that test price. I'll have to pass. I've decided that I'm getting a $200 Fibroscan test, and if my numbers are good, then I'll wait for the triple-crown of treatment---Sof/Vel/Vox. If not, then maybe Sof/Vel now. :)
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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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Treatment options for patients who have failed 6 years 3 months ago #20617

splitdog wrote: Just thought I'd share-- I asked about an HCV RNA NS5a resistance test and it is over $900 USD. They said they could do a cash price of $748. This test is specialized, not many labs can do it, and it is not cheap! :unsure:


Can buy a 12 weeks supply with this $$$
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Treatment options for patients who have failed 6 years 3 months ago #20618

fitz wrote: Considering that is roughly the price for an entire 12 week course of Sof/Vel (Sofosvel) that's a tough choice. 12 weeks of medication or a test which may or may not inform ones choice as to which medication to use.

Perhaps this is a simplistic suggestion, or a course of action you have already taken.... If I were in your shoes, I'd be booking an appointment with Dr James to help sort out the dilemma.

Whatever your decision, you now have options and good ones Splitdog. :+1:


I think Sof/Velp is good even with presence of RAVs. Probably just need to do the treatment a bit longer.
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Treatment options for patients who have failed 6 years 1 week ago #22920

Thats pretty well where i am now. I have been recommended the Sof/Vel/Vox by a Doctor friend in the USA. Just not sure about availability and time frame. Speaking to GP2U tomorrow.
dw
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