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Post Info TOPIC: 2015 AASLD Key Study Reports
Tig


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2015 AASLD Key Study Reports
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With the current interest in the Sov/Velpa/GS9857 (Voxilaprevir) trials, I saw this article and wanted to share it. It addresses treatment experienced results in GT 1 and 3's. Interesting...

Sov/Vel/9857 6+8 weeks AASLD 2015



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Tig

66 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 8+ years!

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Hi Matt,

Good article. I worry that patients are being followed by Fibroscan only. Obviously it is easier to get patients to agree for Fibroscan followup, rather than biopsy.

My problem with Fibroscan is that inflammation itself plays a part in the reading. An influx of inflammatory cells increases the score. After SVR, inflammation should be minimal, apart from when cirrhotics are resorbing and remodelling necrotic nodules. In my case, a reduction in the Fibroscan from 30.1 to 8.8 after 18 months is unrealistic. I'm hoping that researchers can get more SVR patients to agree to biopsy followup.

The figure of about ~50% improvement in at least 1 Fibrosis stage in cirrhotics confirms earlier studies, but it takes at least 2.5 years.

I was always told that the F3-4's and maybe the F3's still need screening for HCC after SVR. The risk is greatly reduced, but some cases do occur which is a shame. I still regard myself as cirrhotic, so the 6 monthly Ultrasound is required. As I said earlier, I'll get a biopsy next year and that will give a more accurate picture of how my fibrosis is going.

Cirrhotics should get a good indication from the platelet level, albumin level and liver enzymes. Normal (or improving platelets) and a normal albumin indicate a normally functioning liver and spleen. Normal (particularly low normal) enzymes show the liver is working well, with little inflammation. Cirrhotics with these parameters have every reason to feel confident. Cheers.



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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

Tig


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Hey Mike,

Yep, I heard that too... Big WOOT!!! That's the encouraging news we like to hear. I want the time to eradication to be ramped up a bit though. 15-20 years is unreasonable, if it's because of the cost of care, fibrosis scores and prescription prices. The powers that be can do better than that. Research and development have done their job. Now it's time to make it readily available.



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Tig

66 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 8+ years!

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I'm sure this is part my brain fog, part senility, part bad hearing, but what does she say at marker 2:21? "With many of the patients actually going back to normal liver after ________"?

Good information Matt. Thanks! This information generally coincides with what my hepatologist has told me. I was told my cirrhosis was decompensated in Jan 2014. One of my recent HCC MRI final reports stated "mildly cirrhotic". This may be due to a difference in interpretation but considering I have been actively treating with either Sov / riba or Harvoni for 22 1/2 months of the time since and have also been alcohol free, my liver has likely regenerate somewhat before my actually achieving SVR. If I indeed achieve SVR after this round of Tx is done then I may be in line to live quite a while with the liver I have and with less chance of HCC. Cool!



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60 yo, geno 1a, Dx 1994 HCV-HIV co-inf, Dx 2013 decompensated cirrhosis
Tx #1 - 24wks Sov+Riba /SOT 7-24-2014/UND@EOT/DETECTED@EOT+16 wks
Tx #2 - 24wks Harvoni /SOT 7-25-2015/UND@EOT,+12,+24,+52 = SVR

Mike

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Very interesting video, Matt.  Encouraging news that around 60% improve by one stage post SVR.  A bit nerve wracking that still no definitive answer about how long to track for HCC post SVR.  A bit unsettling that one person developed HCC who had advanced fibrosis and not cirrhosis during post SVR study.  So basically more studies are needed.

Thanks for posting.

 



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Dx. 2005-liver bx.: stg 2/gr 1. at that time  - GT 1a multiple transfusions in 1981.  Started Sovaldi and Olysio 1/16/14  (No prior treatments) Q80K present.  UND week 4,8 and at EOT.   UND at wk 4EOT, Und at wk 8EOT  SVR 12!!!..SVR 24 :-)

Tig


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Excellent information, Matt. The video should give all of us with advanced fibrosis, renewed hope for fibrosis regression. I recommend those with these questions, to take a few minutes and watch the summary video. It's worth your time!



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Tig

66 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 8+ years!

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Hey All

This thread will be dedicated to the 2015 AASLD / (American Association for the Study of Liver Diseases)

This convention / Conference is held once a year with the latest info on Hep-C and related information. 

Post any info that seems relevant or that which might interest you or our membership.

For Example this topic on Studying Regression In Liver Disease.

Check this great link / video

http://hepatitiscnewdrugs.blogspot.com/2015/11/watch-patients-treated-for-hepatitis-c.html

More to come

matt 



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"And in the end, the love you take is equal to the love you make"

61 year old Geno type A1, F4 Cirrhotic, started 24 weeks on Harvoni 12-17-14 ,EOT-5 week = UND, 8-31-15 =UND , SVR-24 Baby YES! 

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