Sovaldi, Ribavirin and Interferon didn't work with me!

[eidelsharony]

Hi folks! I have been diagnosed with Hep C, genotype 4 with liver cirrhosis. I took  Sovaldi, Ribavirin and Interferon for 12 weeks. The virus was undetected during the treatment and the liver's enzymes were normal. After I finished the treatment on Thursday, I got a fever on Sunday for 6 days. My doctor asked me to go to the hospital and the fever went down by itself. They found that my lymph nodes were elevated. Anyway, after taking biopsy, they said it is just infection. After I left the hospital, my doctor asked me to do blood work. I did it and I was chocked to see that Hep c came back! the viral load was 17 and he asked me to do another blood work and the viral load was 53 thousand. Now the viral load is more than three hundred thousands and the liver's enzymes are elevated again. I am very frustrated now and don't know what should I do. My doctor asked me to Waite until October to get another medication. I have some question and seek for answer's guys: Why Hep C came back? Wasn't the medication strong enough or the length of treatment  long enough? Will the virus resist Sovaldi if I take it with the new medication? Is there any clinical trails shows resistance to Sovaldi it it is used for the second time? How much would be the response rate to a relapser? Will the virus die if it is undetected for a year. In Egypt, where i am from, Hep C patients take the medication for (Interferon and Ribavirin ) for a year and most of them get cured. What will be the best medication on October for my case? What should I do now until October?
Thanks!

[lporterrn]

I am very sorry. Was this your first treatment? You were on the right length of time for this treatment combo. The main reason why patients do not permanently respond is cirrhosis. Because you have cirrhosis your chances of responding to a year of peg/rib are lower than if you didn't, and lower than the 12-week regimen you were on.  The virus should not resist Sovaldi with a 2nd treatment. I don't know what the response rate will be for a genotype 4 relapser, since there are so few of you. If you are nondetectable for 24 weeks after treatment is over, then you have nearly a 100% chance of remaining that way.

This is probably not going to make you feel better, at least not now, but you did not waste your time. You gave your liver a break, and bought some time while you wait. You probably put the brakes on hep C doing liver damage during the treatment. In my case, although the treatment didn't work the first 2 times, my liver biopsy was improved after treatment.

I have seen absolutely nothing on using Olysio and Sovaldi for geno 4, but that might be something you can ask your doc if he has seen any data. 

[eidelsharony]

Thanks, Lucinda! that was my first treatment. I finished it on May, 8. I have liver cirrhosis stag 4, grade 3, but have no symptoms as far as now. How do you know that Sovaldi wouldn't resist the virus if I take it again? Does the virus mutate after the first treatment? My doctor told me If i take Sovaldi and Olysio now, the rate response would be 59%. He recommended to Waite until October for new med. My problem now is waiting. I think of the virus every single day! And i am afraid that it it would cause further damage until October. 

[Mike]

I'm very sorry to hear this. I failed treatment my first time and it can be devastating.

There are a lot of new drugs on the horizon (Sovaldi was just one of many).

Here are some links to drugs that will be approved in the fall:

http://hepatitiscnewdrugs.blogspot.com/2014/07/japan-approves-hcv-daklinza-daclatasvir.html

http://hepatitiscnewdrugs.blogspot.com/2014/04/gilead-announces-us-fda-priority-review.html

Best wishes, Mike 

[lporterrn]

I can't be sure, but assuming you took Sovaldi on a regular basis and didn't miss a lot of doses, then it is very unlikely. This may help: http://www.hepatitisc.uw.edu/page/treatment/drugs/ledipasvir-sofosbuvir

[Anand]

Hi,  I got an email asking "How to post in this forum?" from the forum mentioning eidelsharony.

 To get the best possible answer in this forum is to reveal as much information <as much as you want to> about yourself with regards your Hepatitis C.  We have the two of the best people in Lucinda and Mike.  They have been through the wringer to get to their current stage. When Plan A did not work, they had plan B. Finally Plan C worked.

Important thing is do not give up.  In my blog with my name <anand> I have given my HepC data.  I cannot take Ribavarin due to possible anemia which may jeopardize  my already weakened heart. I cannot take olysio because I take Coumadin to thin my blood.  I am waiting for Ledipasvir to be approved by FDA in October 10, 2014.  I am eagerly waiting for that date with a healthy skepticism that it may not happen on that date. Even it is approved on that date it may take  another month <due to time taken for Ledipasvir to get to the market and the insurance companies>.  I do not worry because my wife worries for both of us!!!. At my age of 77 years I have another element to consider.

Meanwhile I try to be good to my liver with low carb, low fat food with exercise of brisk walking, some weight lifting to keep my self fit. We just drove back and forth <600 miles>from a nearby mountain retreat.  Be active and I also volunteer my services  whenever I we can.

I do not know much about genotype 4.  I hope somebody will answer about type 4.
Anand

[Mike]

What I've read about genotype 4 is that it is most common in middle eastern countries - especially Egypt - and it responds well to the treatment used for genotype 1.

There is no current research for alternatives for those who relapse on a Sovaldi-based treatment regime - as Sovaldi hasn't been around long enough for this group/population to be studied.

Best wishes, Mike

[optimystic]

sorry to hear about the tx results. please DO NOT stress much about this as your immune system is still on the job. there are many treatments coming up to consider. Myself, I have yet to be treated. I am c1a, in may I was at 4,050,000. I have yet to be checked again. I look forward so much to start treatment. Don't despair. it will happen. I know that patience can be trying. Now I am two months closer to new treatments being available, and if my Dr. and I see eye-eye on treatments. I know what I would like to try, and the Dr. would have to be very convincing to sway me from my choices.  God Bless.