Hep C Discussion Forum

Members Login
Username 
 
Password 
    Remember Me  
Chatbox
Please log in to join the chat!
Hep C Discussion Forum -> General Discussion -> Treatment Protocols
Post Info TOPIC: Treatment Protocols
ASDF


Newbie

Status: Offline
Posts: 1
Date:
RE: Treatment Protocols
Permalink  
 

Hi Omar

Can you please let me know how you get sovaldi in uae dubai from pakistan on discount price ,as of my infromation person has to give the undertaking that he will be residing in pakistan while his/her treatment.is it allowed to bring this medicine from pakistan to uae.please share this information.As I also need to start my treatment with sovaldi.

 

Regards

 



__________________
Omar


Member

Status: Offline
Posts: 25
Date:
Permalink  
 

Thanks everybody

I think I need to see another Doctor who has some sort of experience with Sovladi treatment.

Regards
Omar

__________________

Male 31 Years Old

Diagnosed with HCV GT-3a in June 2014

Sovaldi+Riba for 24 weeks started on 8 August 2015

 
Tig


Admin

Status: Offline
Posts: 9284
Date:
Permalink  
 

Hi Omar,

Here is some data on resistant mutation secondary to Sovaldi. Even if a mutation develops, it is short lived and will not impact future treatment with Sovaldi.

Tig

 

Resistance: Sofosbuvir has a high genetic barrier for resistance. To date, investigators have identified three amino acid changes in subjects who received sofosbuvir: L159F, S282T, and V321A. 

  • Investigators identified the  L159F and V321A mutations in a small number of individuals with HCV genotype 3a following treatment with sofosbuvir, but these mutations did not lead to phenotypic resistance.
  • The L159F mutation has been observed in patients with hepatocellular carcinoma and genotype 1a or 2b who were receiving prolonged courses of sofosbuvir (up to 48 week) while awaiting liver transplant; in these patients, the presence of the L159F and/or C316N mutations at baseline was associated with virologic breakthrough relapse post-transplant.
  • The S282T mutation was detected post sofosbuvir treatment in one patient with genotype 2b, but the patient had received sofosbuvir monotherapy; the isolate with the S282T mutation had a mean 13.5-fold reduced susceptibility to sofosbuvir.

 

http://www.hepatitisc.uw.edu/page/treatment/drugs/sofosbuvir-drug



__________________

Tig

68yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

Hep C FAQ   Lab Ref. Ranges  HCV Resistance

Signature Line Set Up/Abbreviations   Payment Assistance

 
Marktq1


Member

Status: Offline
Posts: 28
Date:
Permalink  
 

  1. Apparently Gilead have extended the right to manufacture sovaldi that 8 Indian companies have to include GS5816 and are seeking approval for Gs5816 before the trial results are complete !
  2. As far as I know retreat ment with sovaldi is usually possible only if you are a null responder is it a no go but  this is extremely rare  If tratment fails because of resistant virus mutations developing then it is likely sovaldi in a different combination can be tried
  3. Most important you need to speak to a good doctor


__________________

60 yo male cirrhotic fibroscan 23 base VL 105000 G2 alt250 ast 200 bil high started trial nov. 6 week results alt 32 ast 30 VL blinded other tests normal range
Omar


Member

Status: Offline
Posts: 25
Date:
Permalink  
 

Hi Mallani

Thanks for the advice and detailed explanation.....

However, If there is any chance of resistant mutation to Sovladi, is it worth taking a risk? Bcoz I am not sure about the availability of the above said GS-5816 in UAE or Pakistan in near future at least.

Regards
Omar



__________________

Male 31 Years Old

Diagnosed with HCV GT-3a in June 2014

Sovaldi+Riba for 24 weeks started on 8 August 2015

 
mallani


Guru

Status: Offline
Posts: 3398
Date:
Permalink  
 

Hi Omar,

I'd find a new doctor. For a start, Olysio is useless in Geno 3.

Peg/Riba for 24 weeks is the old SOC for Geno 3. The SVR rate is between 65-80%.

Sovaldi/Riba for 24 weeks is the new SOC for Geno 3, whether Rx-naive or not. The modified Valence Trial showed an SVR rate of 94%.

Resistant mutations to Sovaldi have not been an issue. Gilead are currently trialling a new NS-5A blocker called GS-5816. It will be used with Sovaldi and has produced SVR rates of close to 100% for Geno 3.

Find someone who will prescribe 24 weeks of Sovaldi and Ribavirin. Cheers.



__________________

Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
Omar


Member

Status: Offline
Posts: 25
Date:
Permalink  
 

Dear All

I finally got the first bottle of Sovaldi (alongwith Riba) from Pakistan at the discounted rate.

I visited a Gastro Doctor yesterday here in UAE and told him that I want to start the treatment with Sovaldi+ Riba.

He told me the treatment protocols for GT-3 should be:

- Sovladi + Olysio + Riba    

- Sovaldi + Ledipasvir  (Harvoni)

He told me Sovaldi+Riba alone has many relapses (particularly in GT-3), and if God forbid there is a relapse or there is "resistance mutation" against Sovaldi then there is no alternative treatment.

I told him that chances of getting Harvoni or Olysio at discounted price in UAE or Pakistan are very remote (although its available in UAE and free for UAE nationals only).

In that case, he advised me to go for the conventional Peg-IFN + Riba treatment as it is much more effective against GT-3.

About my question regarding side effects of Peg IFN+Riba, he replied that there are no dangerous side effects and you can easily bear them.

I have researched the forum and internet for relapses of Sovlaid, and found similar material where a few people treated with Sovaldi+Riba have relapsed.

Any thoughts on the above, as I do want to start treating this virus.

Additional information: I have a desk job and work 5 days a week from 8AM to 4PM with 2 days off.  

Regards

Omar

 

 



-- Edited by Omar on Wednesday 28th of January 2015 06:03:08 AM



-- Edited by Omar on Wednesday 28th of January 2015 06:10:14 AM

__________________

Male 31 Years Old

Diagnosed with HCV GT-3a in June 2014

Sovaldi+Riba for 24 weeks started on 8 August 2015

 
Page 1 of 1  sorted by
 
Quick Reply

Please log in to post quick replies.
Hep C Discussion Forum -> General Discussion -> Treatment Protocols
Legal Disclaimer:

THIS FORUM, IT'S OWNERS, ADMINISTRATORS, MODERATORS AND MEMBERS DO NOT AT ANY TIME GIVE MEDICAL ADVICE AND IN ALL CASES REFER ANYONE HERE TO SEEK APPROPRIATE MEDICAL ADVICE FROM THEIR DOCTOR.