resume ledifos after a while

[marian]

Hi,
I took Ledifos for 12 weeks but I didn't manage to get rid of the virus. Shall I resume the treatment after a while, but for a longer period, say 24 months? The virus load is about 135000. Does it make sense to try again or the cause is completely lost with ladifos because the virus get resistance to Ledifos?

[gnatcatcher]

Hi, Marian.

I did a search on "ledifos" and see that it is the generic version of Harvoni in India and that, like Harvoni, it is to be taken strictly under medical supervision. Your doctor is the best person to guide you as to what to do next, but the following may be helpful.

The test that showed that your VL is still around 135,000 -- was that test taken at the end of treatment? If so, some people who still have a viral load at the end of treatment go on to clear the virus. The test that is taken twelve weeks after the end of treatment is the important one: if undetected then, you are considered cured.

If you are still detected twelve weeks after the end of treatment, then your doctor may want to perform resistance testing before deciding what to prescribe next. Hepatitis specialists usually follow the IDSA AASLD Guidelines, which are updated whenever new medicines get approved or new scientific studies change best practices. Here is the link: http://www.hcvguidelines.org/full-report/retreatment-persons-whom-prior-therapy-has-failed

Best wishes,

Gnatty

[marian]

Thanks a lot for the quick and documented reply. The question now is to find a physician able to check whether or not the virus is resistant to the treatment.
Marian

[Lynn K]

Some patients were retreated successfully with Epclusa not sure if that is available overseas yet or what the name is.

I failed 12 weeks of Sovaldi and Olysio and retreated with Harvoni for 24 weeks plus we added ribavirin a few weeks after I started so my overall treatment was 24 weeks Harvoni and 15 weeks of ribavirin.

Were you not under the care of a physician while you were on treatment who followed your care?

[marian]

Thanks a lot for optimistic solution. I will be supervised by a physician for sure, whom I am looking for now.
Marian

[Gaj]

Hi Marian,

Sorry to hear of your relapse. While these new medications give +90% cure for most patients on their first attempt this does still mean that a small group of us do relapse at the end of treatment. Don't be disheartened by this, we may take a little longer but we will succeed!

The others have provided excellent advice about seeking expert medical guidance regarding what steps to take next. I'm not sure where you are located or the available medical support so a couple of extra thoughts:

Resistance testing can be a great option that is useful to choose the most suitable medication where there are multiple choices available. But you should remember that it is about improving the odds rather than being a guarantee so if lack of availability or affordability rules testing out do not despair as there are other approaches that can be taken as below.

Retreatment usually calls for "longer", "stronger" or "extra" (pick two of these). An (non-specific) example for someone who has already tried Harvoni may be something like 12 weeks Epclusa + ribavirin (stronger and extra) or 24 weeks Epclusa (stronger and longer). But this will vary by genotype and liver status which is why specialist advice is important.

If you struggle to find a suitable specialist you could try asking here while indicating the general area you are located and someone may be able to make a recommendation.

[Gaj]

Some patients were retreated successfully with Epclusa not sure if that is available overseas yet or what the name is.

Hi Lynn, there are several epclusa generics currently available including Sofovel (Beacon) and Panovir (Incepta).