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- This topic has 5 replies, 4 voices, and was last updated 6 years, 7 months ago by sabrecat.
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30 March 2016 at 6:15 pm #14646
Sorry you’re here. Please have a look over in the Experts Corner for the latest expert advice on retreatment.
http://fixhepc.com/forum/retreatment-corner.html
Don’t let the fact your first treatment did not bring the results we hoped for cause you to lose hope. Most people who retreat will clear.
YMMV
7 March 2018 at 4:30 am #27526Hello all,
I needed to be retreated quite a while back and am now virus free to date.
Need LFT’s done again in June and as I am still fit fighting fit so I expect my liver is okay virus wise.
Been lucky with liver scans to date as well.
I was looking through the list of sub categories in this topic and all the posts are months and years old.
Just wondering if treatment had got to the stage where treatment failures are now uncommon.
Maybe ‘retreaters’ like me have gone the way of the Dodo? If so, well and good.
Jeff
7 March 2018 at 10:02 am #27532Hi Jeff, glad to her of your re-treatment success, that’s really great. I believe that treatment failure with the new medications (and their good quality generics) is less than 10%, which is amazing, especially compared to the older medication failure rate of 60%.
Making the world a better place – one patient at a time.
10 March 2018 at 11:29 am #27549Hi sabrecat,
You were one of my fellow retreaters and I’m so happy that the virus is gone and things are going so well.
As Mar said the treatments have a good success rate although realistically there will still be a small percentage of relapsers. Posts like yours are great to remind us that there are so many options now for the very small percentage like us that don’t beat it first time around.
Great news sabrecat.
Coral
12 March 2018 at 3:24 am #27560Maybe ‘retreaters’ like me have gone the way of the Dodo? If so, well and good.
Hi Jeff,
Nothing has really changed in terms of success rates although going a little longer in GT3 definitely helps.
The peak of originator DAA use was around 2015Q2 – 2016Q1 when there were around 160,000 patients being treated each quarter. In 2017Q4 that number was 80,000 so over the last 2 years, the number of people treating with originator medication has fallen to 1/2 what it was. The situation for generics appears similar and we only help about 1/2 as many people as would have been the case a year ago.
So the major reason is there are less people treating so fewer people relapsing.
Another reason you don’t see much here is that most of the hard cases (cirrhotic past treatment failure) have either been successfully treated or died. This leaves a relatively easier population to treat where the SVR rates are over 95%.
The other significant change is that 3 years ago I was one of the only doctors prescribing generics. Over time other doctors have seen the results themselves and started prescribing and of course, have had relapses. The conversations have tended to be in the background involving me the patient, their doctor and sometimes others. Mostly we’ve settled on adding Sofosbuvir to Viekira or Zepatier or adding Asunaprevir or Simeprevir to Harvoni or Sovaldi/Daklinza to produce the Vosevii you have when Vosevii does not exist. Anyone who has worked with HIV understands that 3 drugs (targets) are much better than 2, however, the guidelines (both AASLD and EASL) and the various government/insurance funding requirements, and to a degree ethical and medicolegal considerations, dictate this is better done on the QT with informed consent from those that need to know.
Almost all the patients who relapsed the first time have been successfully retreated the second time. There are a couple of exceptions – one who failed 12 weeks Sof/Dac and then 24 weeks Harvoni who cleared on 24 weeks Viekira/Sof/Riba. Another GT3 who is still on maintenance Sof/Dac while we wait for something better (they were bucket list unwell prior to treatment and travelling well on HIV style maintenance).
YMMV
13 March 2018 at 10:10 am #27574Thanks for this information. In the course of reading it, I stumbled with the term “originator DAA’s” so I googled the term and come across the following article relating to South Africa:
http://medicine-access.pointofcarejournals.com/article/68da34d5-fa78-4e9a-a40b-95d9d7f566df
All the words and terms are there: affordable, generic, Gilead, patents, and an already burdened health care, system.
From the abstract:
In time, access to lower prices for some originator DAA therapies has materialized; however, to many, this still may be out of reach. Generic medicines for hepatitis C do work and are effective and affordable. If we are going to achieve the objective of the elimination of viral hepatitis, generic medicines will need to form part of the solution.
It took me back to thinking about the many issues that had been discussed on this forum over the years.
Yours all,
Jeff
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