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TOPIC: Should I add Ribavirin to my Tx?

Should I add Ribavirin to my Tx? 6 years 3 months ago #8543

I'm GT1, F4 and I originally intended to take Sof+Led+Riba for 24 weeks.
Things didn't go to plan and my first shipment had no Riba.
I decided to wait until I felt better and my blood tests showed improvements in coping with Riba.
At 10 weeks I don't feel better (mainly fatigue) and my 8 week blood tests don't seem encouraging.
I have significant extra family responsibilities (hopefully temporary) and I don't think I could cope with feeling much worse.
I just received 90 days of Twinvir and 90 days of Riba (no holdup by Customs and Medsafe this time)
Should I start taking the Riba? If so, now or wait until I start the 2nd batch of Twinvir?

Blood test results from 2015-12-31
Haemoglobin:136 g/L ( 130-175 )
Haematocrit:0.409 Ratio ( 0.40-0.52 )
Red Cell Count:4.11 10^12/L ( 4.3-6.0 ) L
Mean Cell Volume:99.5 fL ( 80-99 ) H
Mean Cell Haemoglobin:33.1 pg ( 27-33 ) H
Platelet Count:155 10^9/L ( 150-400 )
White Cell Count:3.9 10^9/L ( 4.0-11.0 ) L
Neutrophils:2.2 10^9/L ( 1.9-7.5 )
Lymphocytes:1.4 10^9/L ( 1.0-4.0 )
Monocytes:0.2 10^9/L ( 0.2-1.0 )
Eosinophils:0.1 10^9/L ( 0.0-0.5 )
Basophils:0.1 10^9/L ( 0.0-0.2 )
Nucleated Red Blood Cells:0.0 10^9/L

Liver
AST:50 U/L ( 10-35 ) H
Total Bilirubin:15 umol/L ( 2-20 )
Alkaline Phosphatase:117 U/L ( 20-110 ) H
ALT:22 U/L ( 5-40 )
GGT:41 U/L ( 10-50 )
Total Protein:76 g/L ( 65-80 )
Albumin:44 g/L ( 34-48 )
Globulin:32 g/L ( 25-35 )

Kidney
Creatinine:91 umol/L ( 60-110 )
GFR Calculation:78 ml/min/1.73m^2 ( >89 ) L

Coagulation
Prothrombin Time:14.4 sec ( 10.0-14.0 ) H
INR:1.1 ( 0.8-1.2 )
GT1 F4 compensated, I/F non-responder 1997
@2015-11-06 VL 3.5 x 10^6, started Twinvir
@2015-12-31 VL:UND
@2016-01-29 started 2nd 12 weeks of Twinvir
@2016-03-01 ALT=42 AST=42, other LFT in normal range
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Should I add Ribavirin to my Tx? 6 years 3 months ago #8548

  • Gaj
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Hi Tim,

The good news is that you are UND. :)

Looking at your other bloods I suspect you need expert medical advice regarding adding Ribavirin to your Tx rather than from layman forum members. Are you being monitored by a liver specialist?

edit: Talking mostly your haemos, etc. re anaemia
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:
Last Edit: 6 years 3 months ago by Gaj.
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Should I add Ribavirin to my Tx? 6 years 3 months ago #8618

  • DrJames
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Hi Tim,

Those numbers look fine. Here is all the trial data for Sof+Led

NAIVE
default: svr: 97%, trials: ION-1 98% (142/145) ION-3 96% 96% (165/172) Aggregate 96.8% (307/317)
gt1a: default: svr: 97%, trials: ION-1 98% (142/145) ION-3 96% 96% (165/172) Aggregate 96.8% (307/317)
gt1b: default: svr: 99%, trials: ION-1 100% (67/67) ION-3 98% (43/44) Aggregate 99.1% (110/111)
F4
default: svr: 97%, trials: ION-1 97% (32/33)
w12: svr: 97%, trials: ION-1 97% (32/33)
w12riba: svr: 100%, trials: ION-1 100% (33/33)
w24: svr: 97%, trials: ION-1 97% (31/32)
w24riba: svr: 100%, trials: ION-1 100% (36/36)
FAIL
default: svr: 94%, trials: ION-3 94% (102/109)
w12: svr: 94%, trials: ION-3 94% (102/109)
w12riba: svr: 96%, trials: ION-3 96% (107/111)
w24: svr: 99%, trials: ION-3 99% (108/109)
w24riba: svr: 99%, trials: ION-3 99% (110/111)

While the 100% cure rate looks impressive with F4 + Riba the 97% represents 1 person. If you look at the numbers there is scant evidence of Riba making any difference. We know that for F3/F4 GT3 patients Riba does not improve SVR rates with 24 weeks treatment, in fact in every +Riba group the results were worse.
YMMV
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