psavic started TWINVIR treatment

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17 January 2016 at 1:20 am #9480
psavic
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- Treatment Warrior
@psavic
Can anyone describe to me what he has done fibroskan.
In Belgrade, (where my score was 16.3 kPa), the doctor asked me to transfer my right leg over left leg, raise your right hand above his head and throw rib part the best I can. At any moment, when he worked with FibroScan, sought to keep my air and not breathing.

In Sofia, the doctor told me to just lie down comfortably, move right hand , and relax. I did not have that ejects rib part to him, to cease to breathe or anything else. The result was 10.2 kPa.
I mentioned when I made the first examination (in Belgrade), I had a virus, and I was completely hoarse, I could hardly talk. (I do not know whether it could affect the result FibroScan)

G1 F1 or F4 (I am not sure) 6. jan. 2014. -> Biopsy -> F1
24. dec. 2015 -> Fibroscan 16.3 kPa -> indicate chirosis
15. Jan. 2016 -> Fibroscan 10.2 kPa -> F3/F4
VL 30.000.000 – may 2015
VL 3.300.000 – dec 2015
Started TWINVIR treatment naive on January 13, 2016.
VL after 21 day UNDETECTED
17 January 2016 at 2:17 pm #9516
Dr James
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- Guardian Angel
@fixhepc
For GT1a 12 weeks Twinvir without Ribavirin gives you a 97% chance of SVR with or without cirrhosis.

1a, F0-3: ION-1 98% (142/145) ION-3 96% 96% (165/172) Aggregate 96.8% (307/317)

For F4, here is the data:

w12: {
svr: 97,
trials: ‘ION-1 97% (32/33)’
},
w12riba: {
svr: 100,
trials: ‘ION-1 100% (33/33)’
},
w24: {
svr: 97,
trials: ‘ION-1 97% (31/32)’
},
w24riba: {
svr: 100,
trials: ‘ION-1 100% (36/36)’
}

w12 == 12 weeks, w12riba == 12 weeks with Riba, w24 == 24 weeks, w24riba == 24 weeks with Riba.

So the entire F4 trials data is based on 134 people of whom exactly 2 failed. You can’t make any statistically valid assertions on that data to say +Riba is better. Note than in a recent n=468 trails of Sof+Dac+/-Riba in GT3 F4 patients all the patients who took Riba did WORSE than those who did not.

YMMV
17 January 2016 at 3:43 pm #9521
psavic
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- Treatment Warrior
@psavic
If I understand correctly, genotype 1a, if it does not take ribavirin, there is no difference in quality between 12 and 24 weeks.
Is it the same for genotype 1b?
I bought twinvir for 24 weeks of therapy, ribavirin for me is now unavailable.
I do not know whether we subtype a or b. It was never established, and given that I have already begun treatment question is whether it is possible to determine.
Is it possible on the basis of the PCR test after 2 weeks and 12 weeks take a decision on the length of therapy? Or take TVINVIR 24 weeks and that’s it?
What is your opinion?

G1 F1 or F4 (I am not sure) 6. jan. 2014. -> Biopsy -> F1
24. dec. 2015 -> Fibroscan 16.3 kPa -> indicate chirosis
15. Jan. 2016 -> Fibroscan 10.2 kPa -> F3/F4
VL 30.000.000 – may 2015
VL 3.300.000 – dec 2015
Started TWINVIR treatment naive on January 13, 2016.
VL after 21 day UNDETECTED
17 January 2016 at 8:39 pm #9537
Enkel
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- Guardian Angel
@enkel
Yes,

I have the same question, it is only for 1a?

Why Gilead then recommends 24 weeks Harvoni for F4? They want to sell more?

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
17 January 2016 at 8:53 pm #9539
kenbasman
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- Guardian Angel
@kenbasman
I started with 10.4 on my fibroscan and my doctor said it was F3, not F3/F4. I wish I could someone could post a clear numerical guide to the F’s for hep c people. I actually just started a thread asking the same question…

HCV 35 yrs G1a F3 Tx naive
started Lesovir-C 15/12/2015
pre tx: VL 5,250,000 ALT 374 AST 208
FIBROSCORE 10.4

4 weeks tx ALT 29/ AST 33. VL < 12 UI/mL 8 weeks tx ALT 29/ AST 34. VL UND 4 weeks after tx UND. SVR4. ALT 24/AST 18
17 January 2016 at 9:15 pm #9540
Enkel
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- Guardian Angel
@enkel
For treatment naive it 12wks or 24 wks does not make a difference (page 1

While for treatment-experience it makes a little bit

Find yourself here

https://depts.washington.edu/hepstudy/presentations/uploads/103/ledipasvir_sofosbuvir_master.pdf

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
17 January 2016 at 10:39 pm #9544
kenbasman
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- Guardian Angel
@kenbasman
Thanks for that, but I am colour blind. I would love to see the numerical listings for the different F’s in numbers and not coloured charts…

HCV 35 yrs G1a F3 Tx naive
started Lesovir-C 15/12/2015
pre tx: VL 5,250,000 ALT 374 AST 208
FIBROSCORE 10.4

4 weeks tx ALT 29/ AST 33. VL < 12 UI/mL 8 weeks tx ALT 29/ AST 34. VL UND 4 weeks after tx UND. SVR4. ALT 24/AST 18
17 January 2016 at 10:42 pm #9546
kenbasman
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- Guardian Angel
@kenbasman
Should have mentioned that this is more out of interest for fibrosis in the liver than for different cure rate scenarios from the HCV

HCV 35 yrs G1a F3 Tx naive
started Lesovir-C 15/12/2015
pre tx: VL 5,250,000 ALT 374 AST 208
FIBROSCORE 10.4

4 weeks tx ALT 29/ AST 33. VL < 12 UI/mL 8 weeks tx ALT 29/ AST 34. VL UND 4 weeks after tx UND. SVR4. ALT 24/AST 18
17 January 2016 at 10:47 pm #9548
Enkel
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- Guardian Angel
@enkel
kenbasman
You are tx naive so you need only three months lesovir c for 97% cure or 12 weeks + Ribavirin for 100% cure rate.

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
17 January 2016 at 11:05 pm #9552
Vororo
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- Guardian Angel
@vororo
Hi kenbasman, psavic,

There is a conversion chart on relating Kpa numbers (liver stiffness) to F-scores here:

http://fixhepc.com/getting-treated/how-to-do-it/doctors.html

In my opinion, Fibroscan only gives a rough indication of the F-score… I had one done, and I’m sure if a different nurse did the test or if it was done on a different day then the Kpa number would probably have been a bit different. But compared to having a biopsy (sample of liver extracted with a terrifying-looking needle) it is non-invasive.

Little personal story:

I also had a liver biopsy done. My specialist told be that he normally does it under a general anaesthetic (for the patient not for him ), because apparently it can sometimes be painful. But because I didn’t know better, I turned up at the clinic having had a full breakfast and he refused to give me a general anaesthetic. So he gave me a local anaesthetic instead, and then did the biopsy while I watched (no pain at all). Weird experience!

In the end, the biopsy showed F0, but the Fibroscan showed F0/F1. Which one was more accurate? Most probably the biopsy. But maybe the sample came from a still-healthy bit of the liver? Or more likely, the fact that I also have a couple of harmless cysts in the liver threw off the fibroscan result a bit. The cysts are just filled with fluid, so they will have a different density from the rest of the liver…

…

Probably everyone on the forum will agree that the F-score should only be used as a rough guide for how many weeks of treatment should be followed, and not as a justification for ware-housing people who are infected with a seriously dangerous virus….

Diagnosed Jan 2015: GT3, A0+F0/F1. Fatigue + Brain-Fog.
Started Sof+Dac from fixHepC 10-Nov-2015. NO sides.
Pre-Tx: AST 82, ALT 133, Viral Load 1 900 000.
Week4: AST 47, ALT 58. VL < 15 (unquantifiable). Week12 (EOT): AST 30, ALT 26, VL UND Week16 (EOT+4): AST 32, ALT 28, GGT 24, VL UND Week28 (EOT+16): AST 26, ALT 22, GGT 24, VL UND Ever grateful to Dr James. Relapsed somewhere after all that... Bummer! Jan 2018: VL 63 000 (still GT3).
17 January 2016 at 11:49 pm #9555
darbara
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- Guardian Angel
@darbara
yes fibroscan should only be seen as a rough guide. Elastography is accurate to a much bigger extent

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
17 January 2016 at 11:52 pm #9556
Enkel
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- Guardian Angel
@enkel
really, i have done Elastography and resulted F1. I thought they are the same

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
18 January 2016 at 2:59 am #9566
Gaj
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- Guardian Angel
@gaj
FibroScan® is the brand name for a particular transient elastography machine but has become the generalised name for the procedure.

Here is some general reading about the process and variations in accuracy:

http://www.racgp.org.au/afp/2013/july/fibroscan/

And research data summary comparing biopsy and fibroscan.

http://www.ncbi.nlm.nih.gov/pubmed/25528010

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
18 January 2016 at 5:35 pm #9681
kenbasman
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- Guardian Angel
@kenbasman
Thanks. i will stop hogging psavic’s progress now. Sorry about that. Psavic, I hope you are feeling way better now that you are almost a week in to your meds! I only interrupted your post because your doctor told you that at 10.2 you were F3/F4 and my doctor told me that with 10.4 I was F3. I don’t know if they use other factors to get to their conclusions but it here is a chart someone graciously posted for me in my own topic about this:
Attachments:
HCV 35 yrs G1a F3 Tx naive
started Lesovir-C 15/12/2015
pre tx: VL 5,250,000 ALT 374 AST 208
FIBROSCORE 10.4

4 weeks tx ALT 29/ AST 33. VL < 12 UI/mL 8 weeks tx ALT 29/ AST 34. VL UND 4 weeks after tx UND. SVR4. ALT 24/AST 18
18 January 2016 at 5:40 pm #9682
kenbasman
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- Guardian Angel
@kenbasman
Vororo wrote ‘Probably everyone on the forum will agree that the F-score should only be used as a rough guide for how many weeks of treatment should be followed, and not as a justification for ware-housing people who are infected with a seriously dangerous virus….”

Absolutely Vororo. I just wanted to know the numbers for my personal knowledge. Thanks for your answer!

HCV 35 yrs G1a F3 Tx naive
started Lesovir-C 15/12/2015
pre tx: VL 5,250,000 ALT 374 AST 208
FIBROSCORE 10.4

4 weeks tx ALT 29/ AST 33. VL < 12 UI/mL 8 weeks tx ALT 29/ AST 34. VL UND 4 weeks after tx UND. SVR4. ALT 24/AST 18
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