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Hep C Discussion Forum -> On Treatment -> Release after Viekira Pack
Post Info TOPIC: Release after Viekira Pack
mcmaklin


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RE: Release after Viekira Pack
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"L31M confers no resistance towards OMV" is this the reason I relapsed?



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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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Thank you - especially this one http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552686/ is very interesting.

As I cannot understand everything of that (I am not a doctor) - do you think waiting for those new Abbvie Regimens is a good way? I would like to add again I have 1b and I have RAVs: In Region NS5A I HAVE L31M and Q54h,  I do not have Y93H. I have no RAVS in regions NS3 or there are not enough to count. 

 



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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,

Good to hear from you again! I'm glad you're getting ready to attack the beast for the last time. There are a number of good protocols that are in use or are getting ready for release that will get you the results you're seeking. Whether you wait for the newest of protocols or opt to try one of the newest wonder regimens, the good news is many RAV's at one site are overcome by the medications blocking another. Adding a third or +/- Ribavirin with others provides high SVR rates. Often the only consideration is the length of treatment. Here is some additional light reading for you that will add to your knowledge base. Please ask if you have additional questions and we'll try to get them answered.

Viral Resistance Optimization GT1

Sov/Velpa/Vox



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Tig

67yo 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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JimmyK


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Greetings,

I had a breakthrough on V-Pack and am presently one week out of a 12 week course of Harvoni and UND so far.

Of note, the data you put up is with regard to a 1a such as myself. But you are a 1b.

Please read the attached. You may want to print and ask your Doctor about it. Just recently released and the info regarding a 1b is pretty promising!

 

JimmyK



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Harvoni TX 2 12 weeks. UND weeks 4, 12 and now EOT + 4 Weeks. SVR-12 09/29/16. All Glory, Honor and Thanks be to God.

"I go to war with the brothers I trust."
mcmaklin


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Hi Tig, Hi all,

I was not here for a while I was waiting for more knowledge. As you know I replased a month after EOT.

What are options for me now? My consultant says that we know we are waiting for, that the most promising option among patients with NS5A mutations seems to be ABT-530 and ABT-493. That the results of researches show that they work better then other drugs against mutations. 

 

Do you have some other data?

Do you know other who relapsed after Viekira+Exviera?

Should I go again for Abbvie that did not cure me or wait for GS-9851?

 

Genotype 1b, TT, now F1,  Relapsed a month after EOT after Viekira+Exviera no Riba 12 weeks in December 2015

As now is 6 months after EOT I know I have RAVs: In Region NS5A I HAVE L31M and Q54h,  I do not have Y93H. I have no RAVS in regions NS3. 



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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 Canuck,

Addressing the Gilead equation, when those links were discussed, the RAV info for the Sov/Vel protocols were limited and treatment success regarding viral resistance was based on a Sovaldi backboned regimen. As the studies progressed and the newer NS5A drugs like Velpa and now the PI, Vox (GS9857) has changed the entire scene. While many RAV's at some sites can be persistent, they are less so at others and exposure to these newest protocols are proving very effective. Aside from exposure to these newest drugs, the length of exposure to them with some current therapies is also highly effective.

This data is so fluid, it's constantly changing and as I can find additional information, I'll post it. What we are witnessing though is very promising.

Sov/Vel for HCV

Treatment Options



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Tig

67yo 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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Canuck


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Tig,

Within that link to Rav's at the NS5A - in that discussion Dr. Sulkowski brings up - I noted that even though he wrote that as recently as Sept of 2015, in my world it is missing the newest drugs, it does not even make mention vel/nor vox and their peculiarities pertaining to pan and ravs.

mcmaklin, Very good and pro-active of you to get your own testing done. I am impressed. C.



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HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)
Tig


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Hey Mak,

Abbvie is working on some things right now called ABT 493 and 530. The Clinical Trial site has some info but no results yet. Here is that info:  Abbvie Trial

Abbvie posted a press release on it here: Magellan 1 Ph 2: Abbvie Press Release

Whether it is more effective than the Gilead offerings, remains to be seen. The Sovaldi combos and triples are pretty darn effective. Looks very promising...



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Tig

67yo 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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Apart from that my consultant is saying that the new Abbvie regimen is going to be very promising? What is it? Even more than Veltapasvir. I am afraid of waiting for Abbvie again.

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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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Hey Mak,

I hope Malcolm will look in and comment on your question. We discussed this recently and here is a link to that thread. I think the new Gilead DAA's, Harvoni or Sov/Vel/GS9857, may be the opportunity you should investigate. Sovaldi is fairly effective against most known RAV's and when combined with a NS5A and NS3/4, the resistance is low.

RAV's at NS5A



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Tig

67yo 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 again. So now I am 5 months after relapsed. To remind you. F1, 1b, Relapsed 4 weeks  after EOT  Viekira+Exviera (12 weeks) in December. Now viral load 24000 

 

 

 

I have just received my RAVs test that I did privately.

 In region NS5A among mutations L31M and Y93H:

 

mutation L31M confirmed to be present,

 

Y93H NOT PRESENT in referral sequence AY045702 for genotype 1b

 

Addizionali confirmed to be present Q54H

 

 

 

In region NS3 I have no mutations D168A/F/H/N/Y/V. And not possible to estimate Y56h (too small viral load, or genotype different than 1b?.

 

 

 

WHAT ARE OPTIONS FOR ME NOW? Is there something coming from Abbvie? Any ideas when can I be treated.

Do you know something about those mutations, what  for and how long to wait?

 

 

 

I have finished  Abbvie Trial Viekira Pack no Riba Nov 2015. 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 undetected. 4WEEKS EOT RELAPSED  



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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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