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The above re-treatment combo is not written very clearly. I would read
(ombitasvir/paritaprevir/ritonavir plus dasabuvir) plus sofosbuvir and ribavirin
to mean
(ombitasvir (NS5A) OR paritprevir (NS3/NS4A) OR ritonavir (HIV protease))
PLUS
dasabuvir (NS5
PLUS
sofosbuvir (NS5
PLUS
ribavarinThis makes two NS5B inhibitors.
Per the indisputable authority of Wikipedia
Dasabuvir acts as a NS5B (an RNA-directed RNA polymerase) inhibitor.
and
Sofosbuvir is a prodrug using the ProTide biotechnology strategy. It is metabolized to the active antiviral agent 2′-deoxy-2′-α-fluoro-β-C-methyluridine-5′-triphosphate. The triphosphate serves as a defective substrate for the NS5B protein, which is the viral RNA polymerase, thus acts as an inhibitor of viral RNA synthesis.But maybe there’s something here I’m missing.
Viekira Pak is two pills … a combo pill of Ombitasvir/Paritaprevir/Ritonavir and another pill of only Dasabuvir.
klhilde wrote:The benefit of adding ribavirin to retreatment is not exclusive to NS5A inhibitors. In a small study of patients for whom a protease inhibitor regimen had failed, most patients were retreated with a protease inhibitor–containing regimen (ombitasvir/paritaprevir/ritonavir plus dasabuvir) plus sofosbuvir and ribavirin. Fourteen of these 15 patients achieved SVR12.
Am I reading that correctly? They used two different NS5B inhibitors together? (Sofosbuvir and Dasabuvir)
Yes – I believe you are correct – in part. Sofosbuvir is characterized as a nucleotide polymerase inhibitor.
This looks like the AbbVie Quartz-1 study where they added Sofosbuvir to their existing Viekira Pak plus RBV regiment (12 weeks).
Some of the details here:
Note the size of the study group – it is indeed very small.
J
GT 1a (~196
Diagnosed Non A/B ’85 – HCV ‘89
Rebetron INF/RBV 17 months 2000 – Failure
Infergen INF/RBV 11 months 2002 – Failure
Viekira Pak + RBV 12 weeks 2015 – Failure
VL Und at +3 weeks > EOT – EOT+12 weeks 2,240k
Resistance Tests – NS5a Q30R
SMV/DCV/SOF + RBV 24 weeks 2016
VL Det <15 +2 and +4 weeks – Und +8 weeks > EOT
SVR4, SVR12 and SVR24 UndetectedSomeone please advise.
Geno 1. Infected for 30+ years.Treated in 2003-2004 with ribivirin-interferon – 48 weeks. Didn’t take.
Applied for and was denied Harvoni by insurance. Rather than wait, I went directly to China (Mesochem) and received generic Harvoni.
Got a local druggist to compound for me and treated.
At 6 weeks was undetected. Just did my blood work at 24 weeks and:
RDW-CV High
Neutrophils – Low
Lymphocytes – High
Monocytes High
ALT – High (7HCV IU/mL – 1098407
HCV LOG IU/ml – 6.04Did I really not clear???
Please talk me off the ledge.
Hi Cruzan,
Sorry to hear your news. Unfortunately even with these new drugs the results are still only about 95% successful overall meaning not all of us manage to acheive SVR on our first attempt. The good news is that for those of us in that position the science and R&D is progressing fairly quickly these days so there are further options available either now or in the very near future depending on our individual situation.
Having recently found myself in a similar situation I would suggest that your best option is to get all your information and results together and have a discussion with someone who understands the HCV retreatment process. One option that I can recommend for that would be a ‘virtual’ consultation over Skype or similar with https://gp2u.com.au who will be able to provide you with good advice as to your various options for the future whether that be retreatment or otherwise.
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
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