Hi all, not sure it this is the right place to ask this question but it is to do with SVR
I am on ciclopsorin which is an immuno suppressant. I am 30 days into my treatment of 84 days. I would just like to know if taking ciclopsorin will possibly effect the chance I have of getting a sustained viral response. I mean will the fact the my immune system is very low give the virus more chance of replicating once I have finished my course.
I would be more than prepared to stop it (not that my derm would be very happy) if I thought for one moment that it would reduce my chance of success.
I just had my 4 week blood test on Friday so don't have any results yet so don't even know how I've responded so far.
GT3a diagnosed Sept 15 believe contacted 25+ yrs ago
VL 1.6mil ALT. 41
Started Sof/Dac Redemption Trial 7/10/16g
Wk 4. Undetectable. ALT. 14
Wk 8 Undetectable
Wk 12. Undetectable End of treatment.
We do suspect that your immune system still plays a role but it's small. The evidence suggestive of this includes past treatment failures (Peg/Riba) being harder to treat and VL > 6 million treatment naive GT1 needing 12 rather than 8 weeks.
That said the cure rates for HIV positive people don't seem to be reduced.
So in short nobody really knows what the impact of cyclosporin might be. Optimists would say none, pessimists would say a lot.
What is useful is an observation from both Egypt (unpublished) and the USA (published) that notes in the Egyptian case that a 4 log drop by the end of week 1 indicates 12 weeks will work, and in the US case that being detectable at week 4 reduces a 92% SVR in GT1 patients on Harvoni by 8-10%.
So if you are undetectable I would suggest being happy and leaving things as planned with 12 weeks treatment. In NOT undetectable then consider extending the duration by 4 or more weeks.