Incase of Harvoni relapse whats next ?

This topic has 42 replies, 11 voices, and was last updated 8 years, 3 months ago by Dr James.

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21 December 2015 at 11:52 am #6892
darbara
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- Guardian Angel
@darbara
Just asking that if one fails on generic harvoni or gilead harvoni whats next treatment for the patient ?

Treatment naive
F 3/4
Genotype 1 a & b
V/L 17 MILLION
Started Harvoni 11th Dec 2015 for 12 weeks
4 weeks VL UND
6 WEEKS ALT 32, AST 34
EOT 03/03 2016 ! UND
ALT 34, AST 26
04.04.2016 SVR 4
26.05.2016 SVR 12
16.08.2016 SVR 24
21 December 2015 at 12:06 pm #6894
Dr James
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- Guardian Angel
@fixhepc
24 weeks treatment with Harvoni

24 weeks treatment with Sofosbuvir + Daclatasvir

12-24 weeks treatment with Sof/Dac or Sof/Led plus Simeprevir

Abbvie Viekira Pak

So longer, stronger or different.

YMMV
21 December 2015 at 12:14 pm #6896
darbara
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- Guardian Angel
@darbara
Thank you, do you mean another 24 weeks of Harvoni after failing 12 weeks ?
In my case I am:
Treatment naive
F4
Genotype 1 a
V/L 1 MILLION
Started Harvoni 11th Dec 2015 for 12 weeks

So if I fail this then what do you suggest ?

Treatment naive
F 3/4
Genotype 1 a & b
V/L 17 MILLION
Started Harvoni 11th Dec 2015 for 12 weeks
4 weeks VL UND
6 WEEKS ALT 32, AST 34
EOT 03/03 2016 ! UND
ALT 34, AST 26
04.04.2016 SVR 4
26.05.2016 SVR 12
16.08.2016 SVR 24
21 December 2015 at 1:44 pm #6904
Dr James
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- Guardian Angel
@fixhepc
At F4 you need 24 weeks to move your success rate from mid eighties into the nineties.

If you’re on Harvoni I would at 12 weeks generic.

YMMV
21 December 2015 at 2:04 pm #6909
darbara
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- Guardian Angel
@darbara
I have been approved for 12 weeks Gilead harvoni which I am taking now but maybe I will have to get another 12 weeks generic myself if this fails and the state wont approve another 12 weeks.

Treatment naive
F 3/4
Genotype 1 a & b
V/L 17 MILLION
Started Harvoni 11th Dec 2015 for 12 weeks
4 weeks VL UND
6 WEEKS ALT 32, AST 34
EOT 03/03 2016 ! UND
ALT 34, AST 26
04.04.2016 SVR 4
26.05.2016 SVR 12
16.08.2016 SVR 24
21 December 2015 at 2:46 pm #6915
Gaj
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- Guardian Angel
@gaj
darbara wrote:

I have been approved for 12 weeks Gilead harvoni which I am taking now but maybe I will have to get another 12 weeks generic myself if this fails and the state wont approve another 12 weeks.

Hi darbara,

Please consider getting the 12 weeks generics to use straight after the Harvoni to allow continuous treatment out to 24 weeks.

If you finish 12 weeks Harvoni and then wait to test if you have cleared and you fail then you will need to start again and do another full 24 weeks treatment in one go. The treatment must be continuous to work properly.

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
21 December 2015 at 2:54 pm #6916
darbara
- Topics: 6
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- Guardian Angel
@darbara
I will get that generic and if I get SVR 12 THEN I can stop at say 16 weeks. You think this is good an idea ?

Treatment naive
F 3/4
Genotype 1 a & b
V/L 17 MILLION
Started Harvoni 11th Dec 2015 for 12 weeks
4 weeks VL UND
6 WEEKS ALT 32, AST 34
EOT 03/03 2016 ! UND
ALT 34, AST 26
04.04.2016 SVR 4
26.05.2016 SVR 12
16.08.2016 SVR 24
21 December 2015 at 3:10 pm #6918
mgalbrai
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- Guardian Angel
@mgalbrai
You need to treat, non-stop for 24 weeks. You won’t know if you achieved SVR until you stop treatment. When you stop, you have to start all over again. You need to get your 12 weeks of generics before you run out or its back to square one. I have 8 weeks extra I am keeping in reserve until I hit SVR 12. I can “loan” you however many you need in order not to interupt your tx.
Mike

Curehcvnow@gmail.com
http://forums.delphiforums.com/generichcvtx

G 1a F-1
Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil
11/17/15 4 wk lab ALT 17 AST 16 <15
11/18/15 Started Harvoni
12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND
1/14/16 Fin. Tx
7/07/16 UND SVR 24
21 December 2015 at 3:24 pm #6922
Gaj
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- Guardian Angel
@gaj
Hi dabara,

It sounds like there is some confusion with terms. SVR12 is tested at 12 weeks after completing treatment.

It sounds like you mean doing a test at week 12 of treatment? And then deciding if you should treat longer?
If this is the case then by the time you get the new supply of meds you will have had a gap where you are not taking medication. If this is the case then you will probably need to start again and do a full retreatment which will need to be the full 24 weeks.

I’m not a doctor myself so can’t advise whether 16 weeks of continuous Harvoni treatment would be enough for you. Perhaps Dr Freeman can? But the usual advice if you have or may have cirrhosis (you are F3/4 and fit this description) is to treat for 24 weeks for very best results. I think shorter treatments are based on economics for the insurer/government/whoever is paying rather than the best for the patient.

G

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
21 December 2015 at 3:29 pm #6924
darbara
- Topics: 6
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- Total: 172
- Guardian Angel
@darbara
What I mean here is that take harvoni for 12 weeks + 4 weeks of generic harvoni. After 12 weeks if I get SVR THEN I WILL stop taking meds after 16 weeks. If I dont achive SVR AFTER 12 i WILL CONTINUE FOR A TOTAL OF 24 WEEKS.
I go for an MRI scan after 4 weeks harvoni + bloods.

I am travelling to asia often in a year. I have 2 trips planned in the next 4 months. I can get the meds from there no problem

As far as Gilead goes they say 12 weeks with or without cirhossis for treatment naive but one can never be sure of their sales pitch.

Treatment naive
F 3/4
Genotype 1 a & b
V/L 17 MILLION
Started Harvoni 11th Dec 2015 for 12 weeks
4 weeks VL UND
6 WEEKS ALT 32, AST 34
EOT 03/03 2016 ! UND
ALT 34, AST 26
04.04.2016 SVR 4
26.05.2016 SVR 12
16.08.2016 SVR 24
21 December 2015 at 3:36 pm #6927
Enkel
- Topics: 16
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- Total: 309
- Guardian Angel
@enkel
go 12 harvoni + 12 ledifos, this is the only way for 95% cure with F4 i think

Male, Fibro F1. Geno 1b. ALT 67 before treatment Viral load 5 million. My huge viral load replicates in my nervous system as I suffer anxiety.
Started Twinvir 12/12/15.
Two weeks
ALT 17 at 2 weeks
Viral Load UND at 2 weeks
ALT 13.5 at 7 weeks EOT
ALT 10.5 at 15 weeks EOT
ALT 13 at 27 weeks EOT, VL UND, Cured
21 December 2015 at 3:41 pm #6931
darbara
- Topics: 6
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- Total: 172
- Guardian Angel
@darbara
yes if I dont get that SVR12 BUT I will take 16 weeks anyway and will see there is no gap

BTW Gilead plans on selling original Harvoni in India from Feburary 2016 , price will be $ 1050 for 28.
The same they have done with original Sovaldi. India there is generic and original.

Treatment naive
F 3/4
Genotype 1 a & b
V/L 17 MILLION
Started Harvoni 11th Dec 2015 for 12 weeks
4 weeks VL UND
6 WEEKS ALT 32, AST 34
EOT 03/03 2016 ! UND
ALT 34, AST 26
04.04.2016 SVR 4
26.05.2016 SVR 12
16.08.2016 SVR 24
21 December 2015 at 3:47 pm #6932
Enkel
- Topics: 16
- Replies: 293
- Total: 309
- Guardian Angel
@enkel
aS FAR AS I know actually there is original harvoni in india

Male, Fibro F1. Geno 1b. ALT 67 before treatment Viral load 5 million. My huge viral load replicates in my nervous system as I suffer anxiety.
Started Twinvir 12/12/15.
Two weeks
ALT 17 at 2 weeks
Viral Load UND at 2 weeks
ALT 13.5 at 7 weeks EOT
ALT 10.5 at 15 weeks EOT
ALT 13 at 27 weeks EOT, VL UND, Cured
21 December 2015 at 3:59 pm #6935
darbara
- Topics: 6
- Replies: 166
- Total: 172
- Guardian Angel
@darbara
But not at $ 1050 its at US prices. The rich in India import from the US as 3 months medicine can be imported with no problem but they wont anymore as it is now in India BUT there is many who feel generic is not 100 % good. For me I think generic is as good as original. There is a difference between fake and generic

Treatment naive
F 3/4
Genotype 1 a & b
V/L 17 MILLION
Started Harvoni 11th Dec 2015 for 12 weeks
4 weeks VL UND
6 WEEKS ALT 32, AST 34
EOT 03/03 2016 ! UND
ALT 34, AST 26
04.04.2016 SVR 4
26.05.2016 SVR 12
16.08.2016 SVR 24
21 December 2015 at 4:02 pm #6936
Enkel
- Topics: 16
- Replies: 293
- Total: 309
- Guardian Angel
@enkel
UP TO NOW AT 700USD PER BOTTLE

https://www.zauba.com/import-harvoni-hs-code.html

Male, Fibro F1. Geno 1b. ALT 67 before treatment Viral load 5 million. My huge viral load replicates in my nervous system as I suffer anxiety.
Started Twinvir 12/12/15.
Two weeks
ALT 17 at 2 weeks
Viral Load UND at 2 weeks
ALT 13.5 at 7 weeks EOT
ALT 10.5 at 15 weeks EOT
ALT 13 at 27 weeks EOT, VL UND, Cured
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