Home Forums Main Forum Genotype Specific Genotype 3 (37%) GT3 just started meds

Viewing 12 posts - 1 through 12 (of 12 total)
  • Author
    Posts
  • #28677
    Paul2018
    • Topics: 1
    • Replies: 4
    • Total: 5
    • Novice
    @paul2018

    Hello Everyone ! I was recently diagnosed with GT3 (Age – 48, VL 365,495 Fscan 18.2 Kpa) . Got it in the nineties. On sofosbuvir+daclatasvir right now. No outward symptoms at all. No other conditions except hypertension having telmisartan 40 everyday. I have a question regarding another drug that I occasionally take i.e. sildenafil citrate (viagra) . Does this drug have any contraindications ? Could someone please reply.

    #28678
    Avatar photoMar
    • Guardian Angel
    • ★★★★★
    @mar

    Hello Paul, and welcome to the forum :) . The University of Liverpool in the UK has a dedicated page for checking interactions between the new Hepatitis C medications (DAAs) and other common medications, and when I checked the ‘Sofosbuvir + Daclatasvir’ combo and ‘Sildenafil’, the result was ‘No Interaction Expected’. You can take a look here https://www.hep-druginteractions.org/checker


    Making the world a better place – one patient at a time.

    #28681
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Paul2018,

    Welcome to the forum!

    There are no interactions between Sofosbuvir and Daclatasvir and Sildenafil. Here’s the report from the Liverpool Hep C Drug Interactions Site.

    ScreenShot2018-11-11at5.00.17pm.png


    YMMV

    #28683
    Paul2018
    • Topics: 1
    • Replies: 4
    • Total: 5
    • Novice
    @paul2018

    Thanks Dr James, Mar. As I have mentioned my fscan score is 18.2 kpa which is cirrhosis. But I do not have any noticeable symptoms at all. Is it normal not to have any symptoms even with a fscan score of 18.2?

    #28684
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Paul,

    Yes it is possible to be cirrhotic with few symptoms.

    With GT3 and cirrhosis you must have ribavirin with the Sof/Dac. You should also have 24 weeks treatment.

    For GT3 cirrhotics Sof/Vel for 12+ weeks (and preferably with riba) is the best 1st line option.


    YMMV

    #28823
    Paul2018
    • Topics: 1
    • Replies: 4
    • Total: 5
    • Novice
    @paul2018

    Hello everyone, after 4 weeks of sof/dac regime my VL is undetected. The doc never prescribed riba. He has said that he may discontinue meds after 8 weeks. I am worried. Is there a possibility of a relapse in future if the recommended 12 weeks is not adhered to?

    As I go to a government facility where the meds are given free, I do not have a say in the treatment.

    #28824
    Songbird
    • Topics: 2
    • Replies: 63
    • Total: 65
    • Recovery Champion
    • ★★★★
    @songbird

    Hi Paul

    Thats great about your being UND. @week4, that is certainly what you want to see,however I would say yes it is worrisome for SVR to stop this regime at 8 weeks.

    As Dr. freeman pointed out earlier the optimum regime for GT 3 W/ cirrhosis is SOF/VEL for 12 weeks (preferably with Riba added for some insurance.)

    However the guidelines do say, and as Dr. Freeman also mentioned if doing SOF/DAC then 24 wks . is recommended also with RIBA.

    I would imagine the DR. will chime in and possibly you can chat with him about adding whatever regime he suggests through him to supplement being only given 8 weeks treatment.

    If you are only at wk. 4 currently ,hopfully there should still be time to work something out with Dr. Freeman if in fact they will not extend this regime you are on.

    Good luck

    S


    Diagnosed: 2001 GT1a , HCV since mid-70’s.
    Biopsy 2010 F1
    Fibroscan and Fibrosure 2018 F2

    Treated in trial 2010 with Dac/Peg/ Riba and Relapsed.

    Resistance test 2017. Have Ns5a Rav Q30r/H58d enhanced from doing Dac.

    Start Tx. Jan 18th/18 w/ Vosevi /Riba 12wks. plus 6 wks.Viekira Pak +Sof/Riba(From Dr Freeman @GP2U)

    VL start: 1.6mill.ALT 125 AST 88
    Wk. 4 Det @LLOQ <15.
    VL Wk.8 UND Alt &Ast 22
    Wk. 12 UND
    EOT:UND

    EOT+12 >>>UND (SVR12)! ALT11 AST13
    Nov6/18 SVR 24!

    #28827
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Paul,

    You have GT3 and cirrhosis (fibroscan > 12.5kPa)

    There are no guidelines anywhere in the world that say 8 weeks of Sof+Dac is appropriate for ANYBODY.

    The 8 weeks guideline for Harvoni for treatment naive, GT1, Viral load < 6 million, LOW FIBROSIS patients are well known to produce inferior SVR12 to 12 weeks and do not apply to you anyway. You need 24 weeks treatment and would have a high probability of relapse if you do only 8 weeks treatment - nobody knows how high because nobody gives that short a treatment. You should be having ribavirin.

    1. What country are you in?
    2. How much longer do you have before you finish the 8 weeks?
    3. When you do find see your doctor about more treatment?

    Here are the EASL guidelines for treatment of cirrhotic patients

    EASL-cirrhotic.png


    YMMV

    #28830
    Paul2018
    • Topics: 1
    • Replies: 4
    • Total: 5
    • Novice
    @paul2018

    I am from India.
    My 8 weeks come to an end on 4th Jan ’19.
    My next doc visit is scheduled on 2nd Jan ’19.

    #28832
    Avatar photoMar
    • Guardian Angel
    • ★★★★★
    @mar

    Hi Paul, if you’re in India, then you should have access to relatively cheap generic HCV medications, and you can ask you doctor where to source 100% authentic high quality generic medications there. I would urge you to follow Dr James’s recommendation of completing 24 weeks of Sof/Dac and Ribavirin instead of the just 8 weeks of Sof/Dac that you may be treated with as that will almost certainly lead to relapse.


    Making the world a better place – one patient at a time.

    #29586
    Paul2018
    • Topics: 1
    • Replies: 4
    • Total: 5
    • Novice
    @paul2018

    It has been a little over nine months since the time I underwent a 3 months treatment at a local Community Health Centre. I was on a Sof + Dac regimen for 12 weeks. The doctor advised HCV RNA test a week ago. Virus was not detected. He has not prescribed any other tests and asked me to come back after six months.

    Apart from a LFT what are the tests that are normally done after treatment?

    #29587
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hello Paul2018,

    Congrats on the cure result.

    In terms of other tests, it depends on how sick a patient is and what has been done previously.

    So, say I treat a patient who is not cirrhotic and relatively well and 4 weeks into treatment their LFTs are normal and PCR negative. I would not do any more tests until SVR12 and then just do a PCR and LFTs.

    At the other end of the spectrum a patient with cirrhosis who was taking ribavirin would get a CBC and CMP (FBC, UEC, LFT) every 2 weeks during treatment and lots of follow up testing including AFP and ultrasound to check for HCC.

    Other tests just depend on the patient and their problems.


    YMMV

Viewing 12 posts - 1 through 12 (of 12 total)
  • You must be logged in to reply to this topic.