Hep C Discussion Forum

Tig · Admin

RE: Test Results Appreciate Input

JimmyK · Guru

Ok current results are in. Doctors Office has put in a request for Harvoni last Thursday so the wait begins.

I am going to simply provide the highlights.

HGB 16.7

Platelets 241

ALT 64

AST 45

Glucose 105

PT 11.1

INR 1.0

Fibrosis Score 0.58

Necroinflammat AS 0.54

Translates F2-A2

Drugs and Alcohol Negative

GT 1A

HCV RNA Real Time 2,359,487

So there you have it. As I see it unlikely to get th e24 weeks but the 12 should be no problem.

Stay tuned!

JimmyK

JimmyK · Guru

Hey Tig,

I posted the one attached below on Feb 4th. This is the test done after I had failed in December. Of note The one I posted this morning was done by Lab Corp. The one below was done at Quest.

Both sets of results produce F2. December barely F2 and March almost F3.

I do not believe a FibroScan would help much as my Doctor tends to believe the FibroSure exaggerates upward in comparison.

Also of note Carolyn is an F4 and they are doing 12 weeks with her and it seems to be working out well so far. She does her 4 week tomorrow.

About the only thing I see as a potential driver is the prior failure but even that if not cirrhotic calls for 12 weeks. Personally I think if my Doc is good with 12 weeks, then I will be SVR by the time the 24 EOT would have happened. I kind of like the sound of that.

JimmyK

Linuxter · Guru

Hi Jimmy,

My labs never had anything about septa so haven't a clue about that other than what the results paper shows.

I looked at my results (mine are Quest) and noticed there are intermediate stages F0-F1, F1-F2 (No F2-F3) F3-F4.

This must be due to Tig's statement regarding accuracy at the ends of the scale, not so much toward center of scale.

More info is always better so hopefully you'll get the Quest results soon.

If you can get an ultrasound fine but I'm doubtful they will provide one with two separate lab results (Just my thought).

It's good news that your liver is not worse, that is for certain, you've got a good team there, they'll make sure you get what you need to be rid of the beast.

Hey, things are moving along Jimmy, glad to hear it!

Keep us posted.

Dave

Tig · Admin

Hi Jimmy,

What is your fibrosis history? Have you ever had a biopsy? I haven't reviewed all of your post history, so it may be there somewhere. Could you add it to your siggy? I agree with your interpretation of A2 F2. But I also feel that these blood marker tests are most accurate at each end of the scale, with questionable accuracy in the middle. If memory serves me, those tests have about a 30% rate of inaccuracy in those ranges. Whether the two labs provide better or different results, I would hope not, but labs do vary.

If you could talk your Hepa into a Fibroscan or biopsy, I would do it. Blood markers can be affected by so many things, but they're utilizing them because of cost. At the very least, I would request another Fibrosure test, and prepare for it in advance. I would eliminate as many variables as possible, avoid anything that might alter results, medications, extreme exercise, be properly hydrated and then I would fast. Whether any of that would make a difference, I don't know.

I do believe that if you are indeed A2 F2, 12 weeks should do the trick. If that is the decision, I would be very confident that the Good Lord has planned it that way! Keep the faith!

JimmyK · Guru

Greetings,

Lab Results are slowly coming in now. Actually I think my Doctor already has most of the others but it is a difference between Quest and Lab Corp. The former is a matter of going to get them and the latter gets posted.

That said it looks like The FibroSure may cause some issues if I intend to pursue 24 weeks as opposed to 12.

I do see what I consider contradictory statements.

0.58 on page 1 is stated to be F2- Bridging fibrosis with few septa, however the scope of 0.58 is both upper level of F2 and lower level of F3 so how is it determined if you have few septa or many septa on an identical number as far as score is concerned?

If I read this correctly then I am F2 - A2. That may be problematic in securing 24 weeks of Harvoni as opposed to 12. The rest of the stuff is academic such as the VL Count.

I'll keep y'all updated as I continue to consider the ticket options.

JimmyK

JimmyK · Guru

Yea well the money is as real as Clyde's' aspirations. Planet Poker.They give you $2k to start off with and you play folks from all over the World. It is quite a bit of fun and as you build up the players are of a higher caliber, I have built a bit more than $6m so far and have been playing for a few years now there.

At one point here I remember asking about the severity of side effects and any connection to breakthrough nd the folks here pretty much determined they were not connected. The HGB went down but not enough IMHO to explain the massive sides I was having. Oh well down for a bit was all.

1) Compliance will be no issue. I get up every morning at 5:55am without exception and walk around to the other side of the bed, make Carol sit up and hand her 1 Harvoni followed by 1 Omeprazol. I recognize she can do it herself but before she started I committed that she would not have to remember when to take it as I would remind her personally. Not 5:50 and not 6:00, 5:55. This morning I tripped over the damn Easter Bunny and made a football out of it! "It's up it's up it's GOOD!"

2) Correct Protocol will be what it is until they absolutely have a silver bullet. Pushing for the Harvoni and I am a little more comfortable if they say 24 weeks but would take the 12 if approved. At this point, from all I have read, I believe this is the correct protocol bet that remains to be seen 12 weeks after all is said and done.

3) Positive approach. I do pretty good on approach. Last time I was kind of a mess and crashed and burned on approach but that was after a smooth take off, slightly turbulent flight followed by a rather foggy landing strip with busted radar, a Mother In Law navigator and a yapping Chihuahua. This one should be literally without issues. wink

My Healthcare Team is among the best and based on the blood letting they just put me through I can see they are on this one with intent eyes. Also I have managed to convince the Doctor that he does not really want me in his office talking his ears off. I am sure by now he would prefer a simple thank you card annually.

I did find it interesting he ordered another Fibrosure when I did one in December. I was thinking he would do VL and CBC but he wrote up the whole enchilada.

Happy Easter Y'all !

JimmyK

Tig · Admin

I hope the Good Lord and the Easter Bunny bless me with a winning hand and pot that size! I could sure use that right now!

I appreciate you posting those results. Looks like things began to breakthrough in November. Just know that your rates of success aren't determined by viral load or blood work. Compliance, correct protocol and a positive approach will show you the success you desire. I'm confident that your healthcare team is in your corner. You got it this time!

Canuck · Guru

Hey,

Ya, that's good to know, the most recent labs. Now we are up to speed with both yours, and hers, she has lovely labs BTW.

Re: Your first born ... Clyde - he is stone-cold against anolog??!! Sounds spoiled to me, just sayin. C smile

JimmyK · Guru

Howdy Tig.

I redacted the thing and have it attached here. Figured since I was in there, and feeling kind of lucky I would also share a hand I was rather proud of.

JimmyK

Tig · Admin

Jimmy,

I was looking for your most recent LFT's and CBC. Did they give you a workup following the breakthrough? I remember the VL spiked to 300K, but curious about the rest. It will be interesting to see the coming results.

JimmyK · Guru

wendyo wrote:
You can wind the watch for Clyde, he will look at it and adore it and enjoy it as you are teaching him to tell time. (Carol will think I have lost it if she reads this!)

Not to worry. Clyde is out firstborn so Carol gets it. My biggest problem is Clyde does not like analog. He is a digital kind of rock ya know?

wendyo · Guru

You can wind the watch for Clyde, he will look at it and adore it and enjoy it as you are teaching him to tell time. (Carol will think I have lost it if she reads this!)

Linuxter · Guru

JimmyK wrote:
Linuxter wrote:
Yeeooooow,
LOL, I hope you fair better than Dudley when Carol gets home ...

Dave
Dude you have to back me up here. This is a clear and documented side effect of Ribovirin right?

Thanks in advance.

np Jimmy, I told Jo I wanted three monitors for my desk the other day and the look she gave me was not one I'd seen in a while ... and hope not to see again for a long while ... it's definitely the Riba!

JimmyK · Guru

wendyo wrote:
tell Carol the watch is for Clyde

I would but he has no hands. The watch does but Clyde is well,,,, you know?

JimmyK · Guru

Linuxter wrote:
Yeeooooow,
LOL, I hope you fair better than Dudley when Carol gets home ...

Dave

Dude you have to back me up here. This is a clear and documented side effect of Ribovirin right?

Thanks in advance.

wendyo · Guru

tell Carol the watch is for Clyde

Linuxter · Guru

Yeeooooow,

LOL, I hope you fair better than Dudley when Carol gets home ...

Dave

JimmyK · Guru

Oh crap I did it again!

I think I am going to blame Ribovirin. I am not kidding now, Ever since I had problems with that stuff I have started collecting Watches!

I just went and bought another one and Carol is going to kill me!

She said just this morning, "You don't even go anywhere why do you need so many watches?" Then she goes on to point out, "And when you get on the Bike, according to Peter Fonda, you are supposed to lose the watch so what is up with that?"

Yes lose the watch!

Too late see below. Pray for me please Carol will be home soon! LOL

JimmyK · Guru

wmlj1960 wrote:
I don't want to jinx you either Jimmy but I'm holding back a big fat smile that probably won't stay inside for 2 weeks. Although I didn't voice my negativity I felt about them wanting to put you on the Zepatier train after you failed v-pak, it pissed me off. If they knew how it feels to fail treatment they would have given you the Harvoni silver bullet without leaving you hanging for the past 8 weeks. I'm glad you'll be following in my footsteps and expect you will have a smooth 24 wk ride just like I did. I'm really happy about this!!!

Dear Brother Mike,

Thank you very much my friend. To be honest I am not at all upset with my Doctor. He was stunned with the failure and such does not sit well with him. He takes it personal. The Zep Train was a thought but never followed through with. Then there was the possible Trial. To be honest he did a lot of consulting with colleagues before arriving at today's decision but has been troubled by the need for Omeprazole. That was the one piece of the puzzle that troubled him.

He spoke to me at length regarding the Proton Pump Inhibitors and the interaction. For one thing he does not agree with the thought of taking Harvoni and Omeprazole on an empty stomach and then waiting to eat for an hour. He asked an important question I think and that is, "..then what triggers the needed acid?" He also asked what Carolyn was doing regarding breaking the fast and I said, Cereal about a half hour later. He said "with milk"? and I replied yes of course.

He then noted the Calcium in the Milk was an alkaline and again asked , "what triggers the acid required?"

He really got me thinking and then stated the data is somewhat of the Chicken or the Egg scenario. Which came first?

That is when I gained the upper hand! That is when I stated;

"And God said, Let the earth bring forth the living creature after his kind, cattle, and creeping thing, and beast of the earth after his kind: and it was so."

Well the Earth does not lay eggs so clearly the chicken came first! :)

Then he asked, so which is which? Is Harvoni the chicken or the egg? Nailed me right then and there and I conceded we were laying a path to create data and not from it.

Yet who among us here are not Pioneers? This is all new and the way we travel it, including trial and error, tears and joys lays the path for those to follow.

Before I can remember, my older sister was actually a true to life Poster Child for Polio. So as far as my blood goes, this is actually kind of cool and I look forward to the adventure!

JimmyK

wmlj1960 · Moderator

I don't want to jinx you either Jimmy but I'm holding back a big fat smile that probably won't stay inside for 2 weeks. Although I didn't voice my negativity I felt about them wanting to put you on the Zepatier train after you failed v-pak, it pissed me off. If they knew how it feels to fail treatment they would have given you the Harvoni silver bullet without leaving you hanging for the past 8 weeks. I'm glad you'll be following in my footsteps and expect you will have a smooth 24 wk ride just like I did. I'm really happy about this!!!

Shadowfax · Guru

It is good news Jimmy and we will all be ready when you are.

I agree, Grace was slick wasn't she? smile

SF

Linuxter · Guru

Hey Jimmy,

Well that was a trip down memory lane ... LOL

Loved it, thanks for posting!

Dave

JimmyK · Guru

Don't go yelling at me now. Did this work?

Tig · Admin

That's good news Jimmy! I won't say congratulations til you have the first bottle of pills. We don't want to jinx this excellent opportunity for you!

I remember Mom saying the same thing about clean, mended underwear, (they actually mended clothes back then)! Those were the days. I just watched an old American Bandstand video from 1967 of Jefferson Airplane singing White Rabbit. Now those were some times!

Your train is due at the station soon. Just stick around and keep us company, we need your humor and support. Then we'll get ready to take that long awaited journey with you!

JimmyK · Guru

Well this is beginning to get embarrassing here.

Pfffffft who cares eh?

OK just back from the Doctor...... again. This time had better do it as I am running out of clean sox!

You remember when you were a kid and Mom would say, "make sure you have clean underwear in case you get hit by a car and end up in the Emergency Room!"

Good ole 50's and 60's!

Anyway new orders are being submitted now. Harvoni x 24 weeks no Ribovirin. Should take about two weeks or so to get approval from CVS Specialty Pharmacy and all the paperwork stuff done.

I will get on the Train when I see the first bottle of Pills. Tired of getting comfortable and having the Conductor come by and say, "Excuse me Sir, could you follow me...and Oh yes, grab your bags.."

I may just go ahead and update my Signature. Kind of reminds me of a friend I had a long time back. Every time he got a new girl he would Ink her name into his arm. They would break up and he would cross out the name and on to the next one. Holy crap the guy ran out of arm before he ever settled down.

I have one name on my arm and it has been there for 38 years. That one will go in the Box when I do never crossed out.

Anyway that is the latest in a series of "What's Next" starring JimmyK

JimmyK · Guru

Never mind and update.

Gilead Sofosbuvir/Velpatasvir/GS-9857 Clinical Trial

Accepted as the only participant in Houston Texas.

I am utterly stunned.

Doctor said he wanted me out of his hair, LOL.

Geeze no kidding blaber mouth!

JimmyK

JimmyK · Guru

Wow and he already respnded as follows;

"Not quite as simple - we have as little data about PPIs as about Zepatier. The fact is that patients in the big study who took PPIs had a lower SVR.
The NS3 resistance doesn't seem to be as important as NS5A, and the different mutations have different sensitivities for each of the drugs.
Best choice may be SOF/DAC or wait for the new Gilead combination in June.
Please make an appointment to discuss."

I guess I need more info on SOF/DAC.

Getting interesting now.

JimmyK · Guru

Closing thoughts now.

The Harvoni Treatment for 24 weeks seems to have the greatest shot at SVR. I know there are those here that believe at adding RBV is probably even better but it was way to rough on me although I do not like admitting that.

The Zep thingamabob does not have the right feel to it. I can't quite put my finger on it but it simply doesn't.

The Doc would absolutely go the Harvoni route if I did not take Omeprozol but I feel I can deal with that and if it were a big no way then Insurance as well as the dosing procedures would simply dictate no.

We will see what he says, but for now this is my position.

JimmyK

JimmyK · Guru

Ok my response now...

I greatly appreciate the time taken in your response.
I checked several of the Harvoni sites and those that seem to add RBV to either the 12 or 24 week regiment of Harvoni are Cirrhotics which fortunately I am not.
The RBV when taken with my first treatment plan had me pretty sick.
I recognize taking Omeprozol with Harvoini can lead to less than successful outcomes however it appears that as long as they are taken together, in a fasting environment in 24 hour increments there is no problem. I know I barely hang on between Omeprozol doses and if I miss first thing in the morning I know it by noon. This tells me while not burning up I am pretty acidic 24 hours after my last does.
Personally based on the data I believe the success rates in my case are higher with a straight 24 weeks of Harvoni and do not require the RBV to achieve SVR12.

Maybe we could sit down again if you feel it is a good idea but I would like to bypass Zepatier with RBV as there is little supporting data and it does have a known resistance to one of my NS3 factors. I think the ingredients in Harvoni deals best with all of my factors and if I take Omeprozol at the exact same time faithfully 24 weeks would result in SVR. The key for me would be not to take any acid suppressant separate from the Harvoni.

Again the RBV seems to be added to Harvoni only in cases of Cirrhotics and not always then. Therefore I think the straight Harvoini for 24 weeks would work and I would love to begin that treatment plan if possible.

If you would like to discuss further I am open to any appointment time and place you feel best."

JimmyK · Guru

Greetings.

I have an update from my Doctor as well as my response.

From The Doc:

Your failure appears to be related to a specific NS5A mutation at the 28 position.
This was reported to be sensitive to 24 weeks of Harvoni. However, the data from a large observational study showed that patients who take acid suppression have a worse outcome. If not for this, all patients were cured with 24 weeks of Harvoni UNLESS they had a L30 or Y93 mutation.
I checked with Merck - lower sensitivity resistance mutations (i.e. 28) did not have an effect on outcome. They recommended 16 weeks Zepatier with RBV.
I can't be sure that this is the best choice, but data are currently limited.
We can try 24 weeks Harvoni (I would add RBV).
AbbVie has a new combination that should take care of this mutation - I will have to see when their trials start.
Zepatier may work based on lower resistance for the 28 mutation.
Future triple drug combinations (probably 2017) may be worth the wait.
Let me know if you wish to have another meeting before we proceed.
Thanks,..."
XXXX

Cont...

Linuxter · Guru

biggrin LOL ... Oh My, I must be behind the curve on that one.

Dave

p.s. Looks like ya got out to do some more fishing, good on ya!

mallani · Guru

Good one, Dave. We actually have a couple of diesel and electric trains now!

Linuxter · Guru

Indeed, that's a most impressive list!

I'd say you're in great hands Jimmy.

Enjoy the ride ...

... as the Train blows it's steam whistle and slowly pulls out of the station and up the hill.

Dave

p.s. I couldn't help but make sure it's an Australian train Malcolm.

-- Edited by Linuxter on Sunday 7th of February 2016 01:58:10 AM

mallani · Guru

Jimmy,

Anyone who has published in those Journals is top shelf.

Follow his advice. Cheers.

JimmyK · Guru

Greetings,

In all fairness to my Hep Doctor I do believe he is quite experienced and a rather good guy. As an example only some of the work he has done over the years includes but certainly not limited to the following papers authored or coauthored. For reference sake only he is N.L. Sussman.

http://www.ncbi.nlm.nih.gov/pubmed/?term=Sussman%20NL[Author]&cauthor=true&cauthor_uid=8629619

It is perhaps my recent failure that has me second guessing everything but the fact is the guy is a Liver Dude of some respect and not some fly by night Voodoo Doctor.

Whatever his response to my inquiry is, I think it is wise to follow his instructions.

Thanks y'all!

JimmyK

Linuxter · Guru

Glad ya made it through that Jimmy, I avoid malls like the plague, I doubt I'd have made it!

Dave

Cinnamon Girl · Guru

Phew, give that man a medal!! If you can survive the mall you can survive anything, Jimmy!! biggrin

JimmyK · Guru

GREAT NEWS!

I survived The Mall!

Tsk tsk tsk

such an idiot!

Cinnamon Girl · Guru

Hi Jimmy, hope you survived your shopping trip, if you`re not back by the end of the day we`re sending a search party out! We`re missing your blabbing already... wink

Very interesting news from your doctor, sounds very promising. Keep us posted!

Tig · Admin

Great bit of news Jimmy! Sounds like you've got a great GP, wish I could get one like that. The old time relationship with our family doctor, has been lost in many instances due to all the changes. Your's sounds pretty sharp and I like the direction this is heading. Keep up the positive attitude and BLAB ON!!

PS: Enjoy the Mall, lol! biggrin

JimmyK · Guru

Greetings,

Just as an FYI I also sent a note to my regular Doctor to let him know what was being prescribed. He saw my wife this morning and mentioned that he had been informed that the Hep Doctor was leaning towards Harvoni/RBV x 24 weeks in my case. They are coordinating somewhat and my regular Doctor ( of 24 years and the guy who referred me to the Hep dude) wants to remain informed each step of the way.

From what he told my wife this morning he was not happy that they had given me VPAK/RBV to begin with. Not sure why but I am pretty sure he wanted Sov and was disappointed.

So once Carol told me this I wrote him a note. Would be kind of cool if he questions the decision or goes along with it. Either way two beats one generally speaking.

If they come to a consensus I am on it either way. If my regular Doctor shows any sort of concern this time then I will need to make the other guy an offer he can't refuse. This is starting to get interesting and a bit fun now.

Thanks y'all and yes I know I blab a lot. I have the day off and Carol is going to make me go to the Mall with her. I think that is right up there with Ribomonster for me. <sigh>

JimmyK

JimmyK · Guru

Thanks Tig and yes, we shall see.

One of the things I also consider through all this is the fact that we, the family here, often refer to ourselves a Pioneers.

No Pioneer has ever set out assured of reaching his goal. I can get on a plane and head from Houston to Seattle and cannot lay claim to being a Pioneer in so doing.

But those before us who walked and mapped the route going into the unknown, they indeed fit the definition.

Someday there will be a vaccine and HepC will be no more common than Polio. Until that time our children are counting on us to take a chance and explore the possibilities of Victory which are but an arm reach away now.

Hey remember this one?

https://www.youtube.com/watch?v=wgB25WBeBxA

LOL ok just call me Mickey and by the way, he tried LIFE.

;)

JimmyK

Tig · Admin

Sounds good Jimmy. Accurate, to the point and respectful. I see no reason to expect anything but a detailed reply, hopefully... You have provided sufficient data to him, to receive supporting evidence for its use in your case. Let us know what you hear. You're not in a position that requires immediate treatment, so weighing your options is an excellent way to approach this. I know you'll have an answer soon and we'll keep your train ready at the station.

JimmyK · Guru

Thanks Malcom.

Below is the note I am sent the Doctor this morning;

Good Morning Doctor, I hope all is well.

In reading the following study;

EASL - The International Liver Congress 2015
50th annual Meeting of the European
association for the Study of the Liver
Vienna, austria april 22-26

In particular the section; Resistance Analysis of Virologic Failures in Hepatitis C Genotype 1-Infected Patients Treated With Grazoprevir + Elbasvir ± Ribavirin: the C-WORTHY Study

The Q80K Mutation which I have is mentioned (NS3) and appears to have no affect on SVR24 although that rate appears to be 88% and that is confusing. If it has no affect why is the SVR different between those with and those without? (Kind of why you are the Doctor and I am the Airplane Engine Expert LOL)

I recognize the study is a year old and there may be more recent studies out there.

In that I am unsure of how to properly read such data, I would like to ask your opinion of my chances at SVR12 and 24 using Zepatier for 16 weeks with RBV? This considering all of my factors GT1a with NS3 mutation Q80K, D168Y and NS5A mutation M28T.

95-100%? 90-95%? 80-90%? or less than 80%?

If we are looking at 88% you are the expert and if you feel that is sufficient I will follow your orders and hope for the best. I think I have simply gotten used to seeing those 95% success stories and such on those neat commercials (sales pitches.)

I appreciate all you do and thank you for your time.

xxxx

Hopefully the guy will not take offense and will respond with his assessment. Remembering back to the old interferon days I had a Doctor once that had me in a roughly 50% success rate and was willing to prescribe. It is my hopes that these Doctors, such as mine who have a lot of history are not simply comparing the better chances today against yesterday and instead are more forward looking hoping to achieve much higher rates.

I guess we will see and as always thanks much for your help!

JimmyK

mallani · Guru

Hi JimmyK,

Like a good read? It's almost a year old, and I remember being disappointed when I first read it. I had high hopes for Grazoprevir.

http://www.natap.org/2015/EASL/EASL_107.htm

You may note: 'Q80K had no impact on SVR24 in patients treated with Zepatier'. Then 'patients with the Q80K mutation had an SVR 24 rate of 88% , compared with patients without the Q80K had an SVR 24 rate of 95%' .????

Also look at Table 6. In replicons, if you had both M28T and Q30H, that caused a 2286 fold resistance to Elbasvir. As a Geno 1a, Q30H is only one amino acid mutation from Q30K. We don't have info on patients like you, with Q80K, D168Y and M28T.

In short, as a Geno 1a, I would pass on Zapetier. Even though I achieved SVR with an anti-protease, I think they should be avoided if possible, unless Sovaldi is included.

Buddy, it's up to you. I know I would prefer Harvoni and Riba, and if I could wait, it would be Sovaldi/Velpatasvir.

Talk to your doctor. Cheers.

JimmyK · Guru

And while waiting on some input from Malcom.....

https://www.youtube.com/watch?v=8jHXu86O01w

Pass the butter please.

JimmyK

JimmyK · Guru

Right now my wife is concerned with taking Harvoni for herself. I know she will do great but she is worried.

I will not allow her to so much as sense any concern on my part which would lead to her wondering about the Doctor she has.

The guys is good and does know his stuff. My RAV consideration is minor as I understand it. I do not see any predicted resistance in my results to this drug whereas there is to some degree with regard to Harvoni.

I am doing the Z and will with it destroy this lousy Dragon. Riba will bring me down a bit but NOT to my knees.

Let's get on with it.

JimmyK

Cinnamon Girl · Guru

Hi Jimmy, yes I`m sure the cost must be a factor here, and I wouldn`t want to think of you embarking on a course of treatment until you`re completely happy about it. I agree with Tig that you should sit down with your doctor and discuss all your concerns, and please don`t feel rushed.

The question of RAVs is Malcolm`s area and I`m sure he`ll be able to answer a lot of your questions too. Zepatier is so new and you`re our first member to be prescribed it, but I`m sure there`ll soon be others jumping on the same train to keep you company!

Wishing you the very best of luck! smile

Tig · Admin

Yes, that's the info I was thinking about. Have an honest sit down discussion with the doc and present your concerns. Obviously from the literature, he/she feels the 16 week protocol with Riba provides adequate rates of success to warrant the consideration. You can always say no or ask to delay treatment until some real time results begin to flow in. I'm sure from what I've read, pricing is a big consideration and doctors are looking for effective alternatives to Gilead. My question is, what is considered the acceptable rate of success with Zepatier when there are known RAV's to consider versus the known future treatments on the near horizon? 5-10% reductions in SVR may not seem like a lot to some individuals, but 1-5% to those of us in the trenches is huge. How much time do you have to decide?

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