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Hep C Discussion Forum -> On Treatment -> RELAPSE AFTER VIEKIRA PACK?? PLEASE HELP
Post Info TOPIC: RELAPSE AFTER VIEKIRA PACK?? PLEASE HELP
mcmaklin


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RE: RELAPSE AFTER VIEKIRA PACK?? PLEASE HELP
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This test that I have to repeat and that says that 27000 of Viral Load is still there is 4 weeks after treatment.

How could the mistake happen.... I am waiting.



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2nd Vosevi12wks- SOT Sept 12,2018 to EOTDec 5, 2018. Pre-trtmnt - VL 1.4 mil, ALT 45, AST __, ALP 69, GGT 90. 2 week - VL 49, ALT 26, AST __, GGT 53. 4 week-VL <15, GGT42 other normal, 5week: ALT 17,AST 27, Bili 11.8, ALP 68,GGT 36,15X VL12., 6week ALT 19,AST 26,Bili 16,20,GGT35, VL<12,8W UND
Tig


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We have seen people test Undetected during treatment and Detected at the end of treatment. That used to mean a relapse when the Interferon treatments were going on. Not the case now. These drugs work differently and as stated in that article, it's entirely possible to be SVR12 anyway. Some doctors don't take a viral load until EOT+12 because of the delays in SVR. It's also true that the majority of relapses occur during the first four weeks after treatment ends. That doesn't mean you should assume you have failed treatment though. It's the EOT+12 viral load that determines success or not. I wouldn't start considering other treatments until after you see those results. 

One other thing, yes, testing mistakes do happen. Whenever a result comes back that is questionable, it's always wise to repeat it. 



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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!

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wmlj1960


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Sorry about that. It means that as long as you are still alive then you will beat this HCV. So don't go getting run over by a train and you will beat this virus. One step at a time. 1st step is to see what the re-test result is, then go from there. Let us know when you get that result.



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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

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mcmaklin


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Please forgive me as English is not my native language and sometimes I  am not able to understand things like "But it's not over until we are 6 feet under and the chance of that is much slimmer than the chance of being cured of HCV. "



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2nd Vosevi12wks- SOT Sept 12,2018 to EOTDec 5, 2018. Pre-trtmnt - VL 1.4 mil, ALT 45, AST __, ALP 69, GGT 90. 2 week - VL 49, ALT 26, AST __, GGT 53. 4 week-VL <15, GGT42 other normal, 5week: ALT 17,AST 27, Bili 11.8, ALP 68,GGT 36,15X VL12., 6week ALT 19,AST 26,Bili 16,20,GGT35, VL<12,8W UND
mcmaklin


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I red the story of  the link you gave me, I am not sure if I understood this right, Somebody was not UND at the end of treatment but then finally he was UND?

I was undetected at week 12 and probably also 3 weeks after treatment, not 4 weeks after treatment. Obviously waiting for the retest, but I do not know what to think, how could the mistake happen.

I am not cirrhotic, it is 1b - it is unlikely as cure rate was 99 or 100%

And false positive saying that there could be 27000 Viral Load? How could this happen?

 



-- Edited by mcmaklin on Tuesday 15th of December 2015 10:26:00 PM

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2nd Vosevi12wks- SOT Sept 12,2018 to EOTDec 5, 2018. Pre-trtmnt - VL 1.4 mil, ALT 45, AST __, ALP 69, GGT 90. 2 week - VL 49, ALT 26, AST __, GGT 53. 4 week-VL <15, GGT42 other normal, 5week: ALT 17,AST 27, Bili 11.8, ALP 68,GGT 36,15X VL12., 6week ALT 19,AST 26,Bili 16,20,GGT35, VL<12,8W UND
wmlj1960


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mcmaklin wrote:
 Are there any chances to be cured?

 Yes, and after receiving the bad news that you just did it may have you thinking that there is not. But it's not over until we are 6 feet under and the chance of that is much slimmer than the chance of being cured of HCV. If your re-test result proves this to be a false positive, which is very possible, then continue on with your life. If not then there is a solution. You will beat this so don't go ruining your hope over 1 test result. Continue on with your life and take the next step. You are F1 and there is no urgency to get cured today. There will be a tomorrow. Hang in there mcmaklin. Your day will come, maybe sooner than you think. Keep us up to date with what's going on. smile



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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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mcmaklin


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Thank you. I only know that my AST was 50 a week ago (it could be from muscles because I was carrying some things before). ALT and GGTP was normal.

I was UND at the EOT.

I will read the link, may it mean that you could be UND for a while at the EOT and 3 weeks after and then again have some viral load?



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2nd Vosevi12wks- SOT Sept 12,2018 to EOTDec 5, 2018. Pre-trtmnt - VL 1.4 mil, ALT 45, AST __, ALP 69, GGT 90. 2 week - VL 49, ALT 26, AST __, GGT 53. 4 week-VL <15, GGT42 other normal, 5week: ALT 17,AST 27, Bili 11.8, ALP 68,GGT 36,15X VL12., 6week ALT 19,AST 26,Bili 16,20,GGT35, VL<12,8W UND
Tig


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Hi Mak,

We were just talking about this and I'm going to give you a link to that thread. It's worth a read. Look at the different links offered too. Our member, Coolheat, tested negative during treatment and positive at EOT. It was a difficult time for her. But the potential to be detectable at EOT, doesn't preclude you from going on to SVR. She went on to SVR12. Be sure to read this article if you missed it.

http://mobile.aidsmap.com/HCV-viral-load-levels-during-treatment-and-speed-of-decline-do-not-predict-cure-with-interferon-free-therapy/page/2962856

Coolheat: http://hepcfriends.activeboard.com/t60913960/results-now-sad-and-confused/

 

Do you have any additional test results at EOT? Do you have the current ALT/AST and a CBC? When I mentioned a false positive, I'm referring to the possibility that the results are wrong. It happens. That's why waiting for a retest is the only way to confirm status. Try to keep your mind occupied on something besides the test. It doesn't help and the stress isn't pleasant at all. Like Coolheat, you may be pleasantly surprised, if not, there are good treatment options available. Let us know when you get your results back.



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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!

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mcmaklin


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And what could be "false positive" indicating number of Viral Load

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2nd Vosevi12wks- SOT Sept 12,2018 to EOTDec 5, 2018. Pre-trtmnt - VL 1.4 mil, ALT 45, AST __, ALP 69, GGT 90. 2 week - VL 49, ALT 26, AST __, GGT 53. 4 week-VL <15, GGT42 other normal, 5week: ALT 17,AST 27, Bili 11.8, ALP 68,GGT 36,15X VL12., 6week ALT 19,AST 26,Bili 16,20,GGT35, VL<12,8W UND
mcmaklin


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Can you please explain this? "We have had people on these all oral protocols be detected at the EOT and go on to SVR12. " Does it mean I could be relapsed and then again healthy?

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2nd Vosevi12wks- SOT Sept 12,2018 to EOTDec 5, 2018. Pre-trtmnt - VL 1.4 mil, ALT 45, AST __, ALP 69, GGT 90. 2 week - VL 49, ALT 26, AST __, GGT 53. 4 week-VL <15, GGT42 other normal, 5week: ALT 17,AST 27, Bili 11.8, ALP 68,GGT 36,15X VL12., 6week ALT 19,AST 26,Bili 16,20,GGT35, VL<12,8W UND
Tig


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Hi Mak,

That's disappointing news to get and I'm sorry you're having to wait for that repeat test. We have had people on these all oral protocols be detected at the EOT and go on to SVR12. The number is low because these new treatments are so effective. I know that's not much of a consolation prize right now, but don't give up yet. There are other options available, but you may want to wait for the newest protocols in the pipeline since your level of fibrosis is not critical.

Before you spend a lot of time and worry on figuring out what might be, wait for your retest results to return and see what they indicate. I'm including a snippet of the information from the AASLD on retreatment recommendations. There are other treatments available if you have to treat again. The new protocols yet to be released may offer shorter courses of treatment too, so wait until you hear back from your trial healthcare team. They may have something in mind for situations like this. Hang in there and good luck on your retest results. The first test could've been a false positive, so lets wait and not cross that bridge until you have to.

http://www.hcvguidelines.org/full-report/retreatment-persons-whom-prior-therapy-has-failed

"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 minimal liver disease, deferral of treatment is recommended, pending availability of data. 

Rating: Class IIb, Level C

 

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."



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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!

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mcmaklin


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Hello,

 

I need your help to associate things. I have finished a month ago Abbvie Trial Viekira Pack no Riba. I am genotype 1b, TT, F1, upon start treatment I had 1400000 units of virus. After 2 weeks 120 units. After a month below the possibility of detection. After 3 months no virus.  3 weeks after treatment (I was doing tests in UK) I was undetected. Today I have received a SAD NEWS.  4 weeks after EOT I received a message from clinical trials to RETEST cause they found 27000 units. I did a retest today and am waiting. In the meantime a week ago ASPAT was 50. If this is a sad news (waiting for confirmation) is there a possibility to retreat me with Harvoni? And for how long? Where there any cases like that?  I was treatment naive. Are there any chances to be cured?



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2nd Vosevi12wks- SOT Sept 12,2018 to EOTDec 5, 2018. Pre-trtmnt - VL 1.4 mil, ALT 45, AST __, ALP 69, GGT 90. 2 week - VL 49, ALT 26, AST __, GGT 53. 4 week-VL <15, GGT42 other normal, 5week: ALT 17,AST 27, Bili 11.8, ALP 68,GGT 36,15X VL12., 6week ALT 19,AST 26,Bili 16,20,GGT35, VL<12,8W UND
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