hep c returns 16 years after success with interferon and rivitol

[tshunkapajuta]

i did hep c treatment 16 year ago, with interferon and rivitol, was just told it may be back.  what treatment is most likely now?
  

[Lizzy57]

Flyin nailed it.

My DH had HEpc for 25+ years before it became Primary Liver Cancer, which was a death sentence 13 years ago. Liver transplant, 84 WEEKS on interferon/ribavirin and then almost immediate relapse, but we knew the miracle Harvoni was in the wings.....and it DID cure DH's genotype 1a in 12 weeks.

Expected to have a normal lifespan now. I guess the worst s/e has been chronic depression. Even tho he's cured and we honestly never really think about the awfulness of the transplant and post TX.

[flyinlynn]

There are other less common ways to be exposed. Are you saying your liver enzymes are elevated? Even elevated liver enzymes (AST ALT) can have other causes than hep c. For example being overweight can cause excess fat cells to form in the liver causing NAFLD (Non alcoholic Fatty Liver Disease). Also some medicines, drinking alcohol or other medical conditions can also cause elevations in liver enzyme tests.

I am guessing they will be checking you with the HCV RNA by PCR test and other possible reasons you could have elevated liver enzymes.

[tshunkapajuta]

i don't drink,never have, and i have also never smoked tobacco in my life.  also no partners who have ever tested positive for anything, only one in last 15 years anyway. never use anyone elses sewing needle, razor ect. because i know i am positive and would never share any of those things. and only meds i'm on are high blood pressure, a potassium supplement, and a muscle relaxer, i don't take much else due to med allergies

[flyinlynn]

Great but still some people have become infected with no idea how. Hep c is not really considered to be an STD for long term  monogamous couples.

But anyway you will find out soon more about what is going on.

Once it is confirmed you are infected with hep c and your genotype is checked then you can determine what is the best treatment available to you.

Not all countries have all the same medications available and they may have different names.

Current recommendations for patients with genotype 3 who previously treated with interferon/ribavirin are as follows.

Without cirrhosis:

Sofosbuvir-Velpatasvir
Fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) one tablet once daily for 12 weeks

Baseline resistance-associated substitution (RAS) testing for Y93H is recommended. If the Y93H substitution is identified, a different regimen should be used, or weight-based ribavirin should be added as an alternative option.

Or alternate treatments:

Daclatasvir *(60 mg) one tablet once daily for 12 weeks plus Sofosbuvir
(400 mg) one tablet once daily for 12 weeks

Or

Glecaprevir-Pibrentasvir
*Fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg) once daily for 16 weeks

Or

Sofosbuvir-Velpatasvir-Voxilaprevir
Fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg) one tablet once daily for 12 weeks

For patients previously treated with interferon/ribavirin with cirrhosis

Elbasvir-Grazoprevir
Fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) one tablet once daily for 12 weeks plus Sofosbuvir
(400 mg) one tablet once daily for 12 weeks.

Or

Sofosbuvir-Velpatasvir-Voxilaprevir
Fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg) one tablet once daily for 12 weeks

Or

Sofosbuvir-Velpatasvir-Voxilaprevir
Fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg) one tablet once daily for 12 weeks plus Ribavirin
1000 mg if <75 kg or 1200 mg if ≥75 kg for 12 weeks (the daily dose is given in two divided doses)

Or

Glecaprevir-Pibrentasvir
*Fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg) once daily for 16 weeks

[tshunkapajuta]

got news today hep c is back, appointment next week.  so i guess we go from here

[flyinlynn]

Wow it took a year to get in to see your doctor to have the HCV RNA by PCR test? Your last comment was June 2018

Or did you treat again since last year? If so what was the treatment?

Do you have the sane genotype and what is viral load do you have do you know that yet?

[flyinlynn]

If you have only had the antibody test that test is of no value. A person who was infected in the past will always and forever test positive for Hepatitis c antibodies. Antibodies are not the virus they are made by your own body when it tries to fight the hepatitis c virus.

If you have had the HCV RNA by PCR test which looks for the hepatitis C virus in your blood and this test is detected for the virus with a result of how many copies of the virus there are per mL of blood then yes you either relapsed (although relapse is not common) or somehow you became infected again with a new infection.

Only the HCV RNA by PCR test will tell you if you are currently infected with hep.

If you are infected withhep c the correct treatment for you will depend on which genotype you are infected with. The correct medicine will be determined by your doctor based on several factors long with your genotype.

But first you need to have the HCV RNA test to find out if you are currently infected and will require treatment.

[tshunkapajuta]

talked to dr today, they are doing more tests, but, the recent showed some change in liver function, already knew i will always test positive, this  is more showing at this time than has in 16  years. already know genotype 3 from before, and have had no possible new exposure, no needle use for over 20 years, no blood trans fusion, ect