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TOPIC: help interpreting resistance analysis report

help interpreting resistance analysis report 4 years 7 months ago #23948

keith
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hi all
I would be very grateful if someone (perhaps Dr F ) could put this report into layman's terms for me .
Last year after early UND response to 8 weeks Harvoni I relapsed at EOT 4.
I was desperate to retreat and obtained a script from MonkMed for SOF/DAC but did not go ahead as advise from some areas was to wait .
when I found SOF/VEL was available I was all pumped up and ready to go until I read about VOX available some time in the future.so now I'm stuck again .
At 71 I don't know how much more waiting time I've got left. Should I go with the SOF/VEL or wait for the triple?
any thoughts you may have will be welcome
Keith

File Attachment:

File Name: HEP.pdf
File Size:147 KB

age 72 location UK
14-2-2015 GT1a 6.8 kpa F1-F2 VL6.46
16-3-16 started 8wks Harvoin
2 wks VL unquantifiable
4 wks VL undetected
8 wks EOT Vl undetected
4 wks post. detected VL 4.07 relapsed
22-5-17 started re treatment via Redemption 2 ,meds via Monkmed 12 weeks Sof Dac+Rbv
Riba via NHS
Starting VL 4.25 log 6.63 ALT 88 Fibroscan F2- F3 8.9 kPa
2 wks VL 2.86
4 wks VL below detectable level
changed Tx to Viekira+Sof+Rbv
6 wks VL undetected
13-9-17 EOT , ALT32, AST28
SVR 4 +12

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help interpreting resistance analysis report 4 years 7 months ago #23949

DrJames
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Hi Keith,

You have neither NS5A or NS5B resistance. This is good, in fact it does not get any better. 12 weeks Harvoni probably would have done the trick first time round, and would probably still do the trick now.

So really 12-24 weeks of Sof/Led or Sof/Dac or Sof/Vel should all work.

I expect going a little longer than 12 weeks would be good insurance and that skiping Ribavirin would be ok.

We can do (and have done) triple Rx now with available meds but I really don't think you need it. Would not hurt, but a bit more expensive.

Triples that can be done right now:

Simeprevir+Sof+Dac
Asunaprevir+Sof+Dac
Paritaprevir+Ombitasvir+Sofosbuvir (Viekira+Sofosbuvir)

The NS3A components are all originator but come from countries where the prices are much more reasonable.

You could probably use Sof/Vel with Simeprevir or Asunaprevir but I have not looked it up.

YMMV

Last Edit: 4 years 7 months ago by DrJames.

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help interpreting resistance analysis report 4 years 7 months ago #23970

coral
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Hi Keith,

Sorry to hear about your relapse (I know how you feel) but good to hear you are continuing the fight. From Dr F's response it sounds like you are well placed to finally kick this with some additional treatment. Good luck.

G1a probably early 1980's, Biopsy F1(2010), F2-F3(2015). VL 5+mill; 2+mill (2014) Tx naive. Accessed Sof/Led through Dr Freeman at GP2U and Buyers Club (lifesavers!!!)
Commenced tx 12/11/15. 9 wk: VL <15 Detected but LFT = Normal 12 week results: UND (Yay!) Due to slow response commenced Sof/Dac 4 Feb for 12 weeks. EOT @ 24 weeks 27 April 2016. (With thanks to Dr Freeman et al). SVR11 result: VL 1,950,000. It's back!
New tx 030916 (Viekira Pak, Solvadi, Ribavirin UND @ 111116. EOT 170217.
SVR12 and SVR 24...

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