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Post Info TOPIC: hep c gen 1b treatment
Tig


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RE: hep c gen 1b treatment
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Hello,

It's unusual to not have a pre treatment viral load. When did they do the last one? It's not critical to treatment, but is nice to have a starting baseline of all your blood work. Generally speaking, your insurance/medical carrier usually requires a viral load before treatment commences.



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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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primadonna


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Hi! How are you all? We finally chose the same scheme Olysio+Grateziano. Did u all give the blood for viral load before starting treatment? Should I do it the same day?



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wmlj1960


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primadonna wrote:

Thank you for detailed information! A lot of things became clear to me now. I'd really like to try either sof+led or sof+dac combination. Planning to talk to the doctor soon.

 Hi again Mariya. Seeing your location was why I previously asked about "medicine that you have access to at this point". In the recent past some of the newer DAA medicines, such as Harvoni (Sofosbuvir / Ledipasvir) have been unavailable in many areas so we'll be interested to know what you find out from your doctor about what options you have. Please keep up up to date on what you find out. 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

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Cinnamon Girl


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HI again Mariya, you don`t need to have your genotype retested, it stays the same.  With Gen 1b you would be able to do any of the treatments which are suitable for Gen 1, including Sof/Led (Harvoni) as long as they are available where you live. 

Let us know what your doctor says.. smile

 



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Jill 

(71 yo, lives in UK)

Was Gen 3a, 

24wks Peg Ifn/Riba, Sep 2010 - Mch 2011

UND @ Wk.4, UND @ EOT, 

SVR Nov 2011 --> Still UND @ EOT + 4 yrs.

 

 
primadonna


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Hi, Jill! Wish you all the best too! Yes I am currently living in Baku,Azerbaijan. 



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primadonna


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Thank you for detailed information! A lot of things became clear to me now. I'd really like to try either sof+led or sof+dac combination. Planning to talk to the doctor soon. I have been reading a lot about it. Sof led is for gen 1, sof dac for all gentypes.  In case I choose sof+led  is it necessary to re-check the gentype as it treats only gen 1?  Has anybody here ever re-checked his(her) gentype?



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Cinnamon Girl


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I just want to add that if you go ahead with the Olysio (simeprevir) + sofosbuvir treatment, there`s no reason why you wouldn`t do very well, this is a very powerful drug combination.  smile

Here`s some recent information about the success rates...

http://hepatitiscnewdrugs.blogspot.co.uk/2016/01/simeprevir-sofosbuviroptimist-1-study.html



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Jill 

(71 yo, lives in UK)

Was Gen 3a, 

24wks Peg Ifn/Riba, Sep 2010 - Mch 2011

UND @ Wk.4, UND @ EOT, 

SVR Nov 2011 --> Still UND @ EOT + 4 yrs.

 

 
Cinnamon Girl


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HI Mariya, welcome, I`m glad you found us!

I see from your profile details that you live in Moscow, so how you proceed really depends on whether you have any better Hep C treatment currently available to you in Russia for your genotype, apart from the Olysio + Grateziano (sofosbuvir) treatment your doctor has prescribed for you.

The recommended treatment guidelines from the AASLD (the American Association for the Study of Liver Diseases) is the main reference point for our members who live in the USA, where all these new drugs are already available.  And although the newer drug treatments are increasingly available in other parts of the world, iIt could be that the treatment you`ve been prescribed is your best option at the moment, in which case it depends whether you are prepared to wait for future treatment options to become available to you. 

I think the best thing would be to discuss your concerns with your doctor and see what he says.  As an F1  you do have plenty of time to wait, although as Tig said, the sooner you can treat the better really.  

Wishing you all the best of luck!  smile

 

(Ps - I noticed your IP address shows your location as Baku City, Azerbaijan, is this where you are currently living?)

 



-- Edited by Cinnamon Girl on Friday 29th of January 2016 12:11:38 PM



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Jill 

(71 yo, lives in UK)

Was Gen 3a, 

24wks Peg Ifn/Riba, Sep 2010 - Mch 2011

UND @ Wk.4, UND @ EOT, 

SVR Nov 2011 --> Still UND @ EOT + 4 yrs.

 

 
Tig


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Here is some additional information on the current recommendations for the treatment of Genotype 1 (a or b). The protocol your doctor has selected is listed and is effective, but they have been getting away from Olysio, in favor of the NS5B companion to Sovaldi (Grateziano), Ledipasvir. Sovaldi/Ledipasvir is better known as Harvoni. Olysio is a NS3/4A protease inhibitor. It blocks the virus replication at a different site on the genetic chain. Simply put, the newer drugs when combined with Sovaldi, like Ledipasvir, work differently by blocking the virus' ability to replicate at a different location. Olysio has different side effects, requires attention to other details, like photosensitivity, potential skin rashes/itching and RAV's. In the beginning, when Olysio was released, it was considered effective, but off label to prescribe it with Sovaldi and many insurance carriers wouldn't pay for it. It was eventually better received and more frequently prescribed, but in the current picture of treatment, Olysio is considered part of yesterday's news.  It's still effective, but not as commonly prescribed now. This of course can vary depending on what country you live in and what's available.

The new drugs in the pipeline are going to be improved in efficacy and a lower potential for side effects. Sovaldi and the soon to be released Velpatasvir is one of those new combinations and is very effective in trials to date. Your fibrosis level of F1 is low, but the sooner you can treat and stop it, the better. There's no reason to wait too long to do this, because you want to put a stop to the progressive nature and damage that HCV causes the rest of your body. Once you achieve SVR, the danger of increasing fibrosis stops and the healing begins. So you could wait for other medications, but how long are you willing to wait? This is something you should discuss with your doctor and consider your options.

Olysio

Sovaldi/Olysio

Harvoni

Viekira Pak



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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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Linuxter


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Hi Mariya,

HCV is very slow acting in the sense that it usually does damage to the liver at a very slow rate, especially early on as with your stage F1 fibrosis. As an example, many of us here have had HCV for 10, 20 even 40 years an not known about it. Liver damage is usually more severe the longer one waits so there is Little or No Reason to Wait to treat HCV, unless you are waiting for the availability of a new drug (or combination drug regimen) to be made available.

Liver damage also depends a great deal on use of alcohol so It's Extremely Important to Stop Drinking Alcohol once diagnosed with HCV to avoid further damaging the liver. All toxins should be avoided so quitting smoking is also recommended and eating well is important (low salt, low processed sugars diet) ... no more junk food (processed food), try to eat fresh fruits and vegetables and lean meats (chicken, fish are probably the best).

HERE are current recommendations for treatment for Genotype 1 HCV.

Scroll down the page until you reach your specific Genotype (e.g. Genotype 1b)

 

Dave

 

 

 

 

 



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63yy,HCV,2b,F3-A1, Sof/Riba,12wks Tx   SOT: 1/20/16, HCV-RNA 9,816,581, ALT 56, Hb 14.6

4wk: HCV-RNA <15 Detected, ALT 15, AST 17, Hb 13.6 EOT: 4/12/16, ALT 18 , Hb 12.9176a2f85d05d9c965eafe199f2ba9ba5.jpg SVR Achieved 7/8/16

 
primadonna


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I was never  treated before. I just found out about it. I read on one site that patients with F1 can wait for treatment. How true is it? 



-- Edited by primadonna on Friday 29th of January 2016 06:59:24 PM

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primadonna


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That was doctor's prescription. But I dont see a lot of people using that scheme. More and more people use sof +led and sof +dac combination. What can you tell about it?



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primadonna


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Hi! Just checked my stage of fibrosis. It is F1. The viral load is 5x10^5 IU/ mL. Gen type 1b. Thanks for showing attention to my post!!! 



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wmlj1960


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Hi Mariya.
 Welcome to the forum. There are options other than Olysio (simeprevir) with better SVR rates. Is there a reason that you ask about Olysio in particular? Is "Olysio +Grateziano" the only medicine that you have access to at this point? Please tell us more about your situation.



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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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Shadowfax


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Hi Mariya,

Welcome and you have found one of the best places for answers and great members to share their experience past and present.

 



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65 yo, GT1A, , Cirrhosis, F-Scan F4 33.5, TX Naive Harvoni 12 wks

SOT 2/9/16 / ALT 187 AST 114 VL 2.3M.    POSTS

EOT 5/2/16  ALT 35/ AST/25  platlets 126 C/B VL UND

EOT +12 7/26/16  ALT 25 /AST 22/ ALP 83  platlets 129 C/B VL UND

EOT + 24 10/18/16 ALT 27/ AST 20/ ALP 71 platlets 153 C UND

 * SVR *
Tig


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 Hi Mariya,

Welcome to the forum. I haven't heard of Sovaldi referred to as Grateziano before. I see that it is an Egyptian generic, if my information is correct. Can you provide us the info that Dave has requested below? Some additional test results, fibrosis stage and if you've ever treated before is helpful knowledge. Here is the AASLD recommendation for 1B, with a link to the entire guideline following.

"Genotype 1b For HCV genotype 1binfected, treatment-naive patients, there are three regimens of comparable efficacy: ledipasvir/sofosbuvir for 12 weeks, PrOD for 12 weeks70,71 and sofosbuvir plus simeprevir with or without weight-based RBV for 12 weeks (or 24 weeks for patients with cirrhosis).72,74,75 Recommendation 10. Treatment options for treatment-naive patients with HCV genotype 1b who are initiating therapy (regimens are listed in alphabetical order): Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) for 12 weeks. (I-A) Daily fixed-dose combination of paritaprevir (150 mg)/ritonavir (100 mg)/ombitasvir (25 mg) plus twice-daily dosed dasabuvir (250 mg) for 12 weeks. (I-A) Daily sofosbuvir (400 mg) plus simeprevir (150 mg) with or without weight-based RBV for 12 weeks (no cirrhosis) or 24 weeks (cirrhosis). (IIa-B)" 

Hepatitis C Guidance



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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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Linuxter


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Hi again Mariya,

Directions to Add a New Thread.

List of abbreviations used on this site (in case you need it).

Directions to add Information to your Signature

 

Dave

 



-- Edited by Linuxter on Thursday 28th of January 2016 06:27:40 AM

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63yy,HCV,2b,F3-A1, Sof/Riba,12wks Tx   SOT: 1/20/16, HCV-RNA 9,816,581, ALT 56, Hb 14.6

4wk: HCV-RNA <15 Detected, ALT 15, AST 17, Hb 13.6 EOT: 4/12/16, ALT 18 , Hb 12.9176a2f85d05d9c965eafe199f2ba9ba5.jpg SVR Achieved 7/8/16

 
Linuxter


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Hi Mariya,

Welcome to the forum, we're glad you are here. You came to the right place, there are a lot of friendly, very helpful and knowledgeable people on this forum.

Can you give a little medical background regarding your diagnosis, your Genotype, Viral Load, Stage of Fibrosis, it will help give better advice?

Some of our more knowledgeable members will be along to help with your original question.

 

Wising you Well,

Dave

Edit: Ahh, I wasn't familiar with Grateziano, a google search indicates that it's Sovaldi (sofosbuvir).

Sorry, I see that you did give your Genotype, but the other information may assist others in giving better advice. Also how long is your treatment?



-- Edited by Linuxter on Thursday 28th of January 2016 06:28:48 AM

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63yy,HCV,2b,F3-A1, Sof/Riba,12wks Tx   SOT: 1/20/16, HCV-RNA 9,816,581, ALT 56, Hb 14.6

4wk: HCV-RNA <15 Detected, ALT 15, AST 17, Hb 13.6 EOT: 4/12/16, ALT 18 , Hb 12.9176a2f85d05d9c965eafe199f2ba9ba5.jpg SVR Achieved 7/8/16

 
primadonna


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 Hello! The doctor prescribed Olysio +Grateziano for hepatitis c gen 1b. Who knows anything about this scheme? Share your experience,please. I need it very much!!!



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