Home Forums Main Forum FixHepC Admin Q & A Should I add Ribavirin to my Tx?

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  • #9588
    Tim-Naylor-google
    • Topics: 1
    • Replies: 11
    • Total: 12
    • Acolyte
    • ★★
    @tim-naylor-google

    I’m GT1, F4 and I originally intended to take Sof+Led+Riba for 24 weeks.
    Things didn’t go to plan and my first shipment had no Riba.
    I decided to wait until I felt better and my blood tests showed improvements in coping with Riba.
    At 10 weeks I don’t feel better (mainly fatigue) and my 8 week blood tests don’t seem encouraging.
    I have significant extra family responsibilities (hopefully temporary) and I don’t think I could cope with feeling much worse.
    I just received 90 days of Twinvir and 90 days of Riba (no holdup by Customs and Medsafe this time)
    Should I start taking the Riba? If so, now or wait until I start the 2nd batch of Twinvir?

    Blood test results from 2015-12-31
    Haemoglobin:136 g/L ( 130-175 )
    Haematocrit:0.409 Ratio ( 0.40-0.52 )
    Red Cell Count:4.11 10^12/L ( 4.3-6.0 ) L
    Mean Cell Volume:99.5 fL ( 80-99 ) H
    Mean Cell Haemoglobin:33.1 pg ( 27-33 ) H
    Platelet Count:155 10^9/L ( 150-400 )
    White Cell Count:3.9 10^9/L ( 4.0-11.0 ) L
    Neutrophils:2.2 10^9/L ( 1.9-7.5 )
    Lymphocytes:1.4 10^9/L ( 1.0-4.0 )
    Monocytes:0.2 10^9/L ( 0.2-1.0 )
    Eosinophils:0.1 10^9/L ( 0.0-0.5 )
    Basophils:0.1 10^9/L ( 0.0-0.2 )
    Nucleated Red Blood Cells:0.0 10^9/L

    Liver
    AST:50 U/L ( 10-35 ) H
    Total Bilirubin:15 umol/L ( 2-20 )
    Alkaline Phosphatase:117 U/L ( 20-110 ) H
    ALT:22 U/L ( 5-40 )
    GGT:41 U/L ( 10-50 )
    Total Protein:76 g/L ( 65-80 )
    Albumin:44 g/L ( 34-48 )
    Globulin:32 g/L ( 25-35 )

    Kidney
    Creatinine:91 umol/L ( 60-110 )
    GFR Calculation:78 ml/min/1.73m^2 ( >89 ) L

    Coagulation
    Prothrombin Time:14.4 sec ( 10.0-14.0 ) H
    INR:1.1 ( 0.8-1.2 )


    GT1 F4 compensated, I/F non-responder 1997
    @2015-11-06 VL 3.5 x 10^6, started Twinvir
    @2015-12-31 VL:UND
    @2016-01-29 started 2nd 12 weeks of Twinvir
    @2016-03-01 ALT=42 AST=42, other LFT in normal range

    #9593
    avatar876.jpegGaj
    • Guardian Angel
    • ★★★★★
    @gaj

    Hi Tim,

    The good news is that you are UND. :)

    Looking at your other bloods I suspect you need expert medical advice regarding adding Ribavirin to your Tx rather than from layman forum members. Are you being monitored by a liver specialist?

    edit: Talking mostly your haemos, etc. re anaemia


    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
    :cheer: :cheer: :cheer:

    #9663
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Tim,

    Those numbers look fine. Here is all the trial data for Sof+Led

    NAIVE
    default: svr: 97%, trials: ION-1 98% (142/145) ION-3 96% 96% (165/172) Aggregate 96.8% (307/317)
    gt1a: default: svr: 97%, trials: ION-1 98% (142/145) ION-3 96% 96% (165/172) Aggregate 96.8% (307/317)
    gt1b: default: svr: 99%, trials: ION-1 100% (67/67) ION-3 98% (43/44) Aggregate 99.1% (110/111)
    F4
    default: svr: 97%, trials: ION-1 97% (32/33)
    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)
    FAIL
    default: svr: 94%, trials: ION-3 94% (102/109)
    w12: svr: 94%, trials: ION-3 94% (102/109)
    w12riba: svr: 96%, trials: ION-3 96% (107/111)
    w24: svr: 99%, trials: ION-3 99% (108/109)
    w24riba: svr: 99%, trials: ION-3 99% (110/111)

    While the 100% cure rate looks impressive with F4 + Riba the 97% represents 1 person. If you look at the numbers there is scant evidence of Riba making any difference. We know that for F3/F4 GT3 patients Riba does not improve SVR rates with 24 weeks treatment, in fact in every +Riba group the results were worse.


    YMMV

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