Aa
Holkira Pak failure?
Hello there
Just wanted to know which meds or treatment the group would consider as best overall effective treatment for hep c genotype 1a, compensated cirrhosis, (previous null responder to interferon and ribaviron)
Just wanted to know which meds or treatment the group would consider as best overall effective treatment for hep c genotype 1a, compensated cirrhosis, (previous null responder to interferon and ribaviron)
Hi!
Thank you So much for that hopeful positive info!!! So you were previously treated with interferon and have cirrhosis as well and you cured on HARVONI? That is Superfantastic!!!! So very good to hear! I was losing hope !
I also thought he would become immune to any future treatments because of the couple he already had ...
If you live in Canada did trillium pick up the cost of this drug? I have no idea about the $ yet as we have an appt with the dr this week and I'm not even sure he will put him on this drug since he relapsed on the holkira Pak- but do you think that is an issue for him not to start the HARVONI?
Thank you So much for that hopeful positive info!!! So you were previously treated with interferon and have cirrhosis as well and you cured on HARVONI? That is Superfantastic!!!! So very good to hear! I was losing hope !
I also thought he would become immune to any future treatments because of the couple he already had ...
If you live in Canada did trillium pick up the cost of this drug? I have no idea about the $ yet as we have an appt with the dr this week and I'm not even sure he will put him on this drug since he relapsed on the holkira Pak- but do you think that is an issue for him not to start the HARVONI?
My husband just finished 24 weeks of this which included the ribaviron
All the while from the first week he was undetected for the virus via the VL
We are so disheartened as we understood the extra 12 weeks was needed because of the cirrhosis and because he tested as a null responder after the treatment in 2009 ( interferon and ribaviron)
Does anyone have anything enlightening to bestow upon us?
All the while from the first week he was undetected for the virus via the VL
We are so disheartened as we understood the extra 12 weeks was needed because of the cirrhosis and because he tested as a null responder after the treatment in 2009 ( interferon and ribaviron)
Does anyone have anything enlightening to bestow upon us?
Curious about your post title I think you are asking about Viekira pak?
I did not take Viekira Pak but people have been havong good results with that treatment also.
Viekira pak is a bunch of different pills 5 I thing spread out over the day plus because your husband is genotype 1a he had to also take ribavirin.
Harvoni that I took was just one Harvoni pill plus the ribavirin.
Congrats on finishing treatment and wishing you both the best
I did not take Viekira Pak but people have been havong good results with that treatment also.
Viekira pak is a bunch of different pills 5 I thing spread out over the day plus because your husband is genotype 1a he had to also take ribavirin.
Harvoni that I took was just one Harvoni pill plus the ribavirin.
Congrats on finishing treatment and wishing you both the best
I have had cirrhosis since Jan 2008. I treated 3 times with interferon based treatment and had no responce to treatment my virus levels never decreased on treatment with interferon and ribavirin in fact they increased.
I treated for 24 weeks with Harvoni we added ribavirin after I started so I took ribavirin for 15 of those 24 weeks.
I finished treatment on May 4th. When I was tested on July 27th 12 weeks after my treatment ended I was still not detected for the virus which is being called cured of hep c. I am going to test again at 24 weeks post on October 19 just to be sure but I expect good results.
I will still have liver cirrhosis and will have to thake care on my liver but at least my hep c is gone and won't be causing any further damage. I will still be tested every 6 months with ultrasound and blood testing (AFP) to check for signs of liver cancer for the rest of my life because having cirrhosis puts you at increased risk of liver cancer but even that risk is reduced because of curing Hep c.
Everyone I have seen that treated for 24 weeks of harvoni so far I have not seen any failures reported
Good luck to you both,
Lynn
I treated for 24 weeks with Harvoni we added ribavirin after I started so I took ribavirin for 15 of those 24 weeks.
I finished treatment on May 4th. When I was tested on July 27th 12 weeks after my treatment ended I was still not detected for the virus which is being called cured of hep c. I am going to test again at 24 weeks post on October 19 just to be sure but I expect good results.
I will still have liver cirrhosis and will have to thake care on my liver but at least my hep c is gone and won't be causing any further damage. I will still be tested every 6 months with ultrasound and blood testing (AFP) to check for signs of liver cancer for the rest of my life because having cirrhosis puts you at increased risk of liver cancer but even that risk is reduced because of curing Hep c.
Everyone I have seen that treated for 24 weeks of harvoni so far I have not seen any failures reported
Good luck to you both,
Lynn
My husband just finished 24 weeks of this which included the ribaviron
All the while from the first week he was undetected for the virus via the VL
We are so disheartened as we understood the extra 12 weeks was needed because of the cirrhosis and because he tested as a null responder after the treatment in 2009 ( interferon and ribaviron)
Does anyone have anything enlightening to bestow upon us?
All the while from the first week he was undetected for the virus via the VL
We are so disheartened as we understood the extra 12 weeks was needed because of the cirrhosis and because he tested as a null responder after the treatment in 2009 ( interferon and ribaviron)
Does anyone have anything enlightening to bestow upon us?
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Per the American Association for the Study of Liver Diesase (AASLD)
HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C
RETREATMENT OF PERSONS IN WHOM PRIOR THERAPY HAS FAILED
http://www.hcvguidelines.org/full-report/retreatment-persons-whom-prior-therapy-has-failed
here is the recommendation for his situation
Recommended regimen for patients in whom previous treatment with any HCV nonstructural protein 5A (NS5A) inhibitors has failed (including daclatasvir plus sofosbuvir, ledipasvir/sofosbuvir, or paritaprevir/ritonavir/ombitasvir plus dasabuvir).
For patients with cirrhosis or other patients who require retreatment urgently, testing for resistance-associated variants that confer decreased susceptibility to NS3 protease inhibitors and to NS5A inhibitors is recommended. The specific drugs used in the retreatment regimen should be tailored to the results of this testing as described below. Treatment duration of 24 weeks is recommended and, unless contraindicated, weight-based RBV should be added.
For patients with cirrhosis or other patients who require retreatment urgently, testing for RAVs that confer decreased susceptibility to NS3 protease inhibitors (eg, Q80K) and to NS5A inhibitors should be performed using commercially available assays prior to selecting the next HCV treatment regimen. For patients with no NS5A inhibitor RAVs detected, retreatment with ledipasvir/sofosbuvir and RBV for 24 weeks is recommended. For patients who have NS5A inhibitor RAVs detected and who do not have NS3 inhibitor RAVs detected, treatment with simeprevir, sofosbuvir, and RBV for 24 weeks is recommended. For patients who have both NS3 and NS5A inhibitor RAVs detected, retreatment should be conducted in a clinical trial setting, as an appropriate treatment regimen cannot be recommended at this time.
Hi me again
Basically if he has failed 24 weeks of Holkira pak (paritaprevir/ritonavir/ombitasvir plus dasabuvir) he will need to be tested for his resistance factors to treatment to best determine where to go from here
The tests would be to see if he tests positive for (technical stuff) the Q80K polymorphism a NS3 protease inhibitor and for NS5A protease inhibitors.
If he tests negative for the NS5A he should be treated for 24 week of Harvoni with Ribavirin.
If he tests positive for NS5A but not the NS3 Q80K he could be treated with Simeprevir (Olysio) and Sofosbuvir (Sovaldi) with Ribavirin for 24 weeks
If he tests positive for both NS3 and NS5A we would need to look for a clinical trial or wait for new medicines to be approved