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Author Topic: Harvoni, After Treatment, Blood Work  (Read 10830 times)

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Offline JimmyK

  • Member
  • Posts: 18
Harvoni, After Treatment, Blood Work
« on: August 04, 2016, 11:33:47 am »
Greetings,

Forgive me if you have a specific thread this should go in. I tried looking but ....

Today is my EOT plus 4 weeks. Just completed a full blood panel including an HCV RNA. The reason for the EOT+4 is not real comforting but things will be as God sees fit.

Short story: Did the V-Pack / RBV last year and had a breakthrough. Cut off week 11 of 12. Production of NS5A/ M28T and NS3/ Q80K, D168Y.

My Doctor, who is pretty sharp is out of Baylor St. Luke's in Houston. We discussed options and decided on Harvoni for 24 weeks. I am an F2 so not cirrhotic. The Insurance Company approved the plan and I began the Harvoni treatment on 04/15/2016. Week 4 I was UND as well as week 12.

Here is where is gets a bit messed up. When placing my order with Caremark/CVS Specialty for the 4th of 6 bottles I was informed Insurance had denied further treatment. That of course turned into a boxing match of appeals. I had 10 pills remaining at that point, when the first appeal went out. The appeal was denied with 4 pills remaining so I kind of went on the warpath.

The second appeal finally was approved! However by that time there was a 9 day gap since the last pill so I opted to refuse shipment. The gap was too great regardless of how tempting it was to tell them to ship. The Harvoni would have reached me with a minimum 10 day gap in treatment.

OK now you know why there was a EOT + 4 Weeks done today.

The 4 and 12 week UND is promising I suppose, but with the RAV's, in particular M28T which is a predicted resistance to Ledipasvir it gets a bit shaky. I recognize the resistance due to M28T is weak, but I also take Omeprazol which also has an affect on Ledipasvir.  (How's that for a double punch?) This entire scenario is the reason for the 24 weeks and yes I recognize that is not in line with the guidelines.

So if I fail today we will again check on RAV's and then from there select a triple therapy. Denial will be very difficult for Insurance in that they clearly caused the interruption to the 24 weeks after approval and then later went on to approve again. The denial, followed by the late approval paperwork is quite valuable if any further treatment is required.
On the other hand if I am UND today, then there is a 98% chance I will be at EOT + 12.

So in the interest of collecting data, mine will be an interesting case to follow as we continue down a Pioneering path to The Cure.

Warm Regards

JimmyK
Logged
Gen 1a HCV PCR Q 3880000, ALT 94 AST 58, F2
Tx 1 Viek/Rib x 12 SOT 10/15/15 Breakthrough_Treatment Stopped 12/29/15

Tx 2 Harvoni x 12, SOT 04/15/16, EOT 07/07/16, UND week 4 and 12. EOT + 4 Weeks 08/04/16 will repeat HCV RNA to determine status due to NS5A and NS3 findings at EOT TX1 12/29/15. (M28T and Q80K,D168Y)
Considered an "interesting" case. Update EOT + 4 Weeks HCV RNA came back UND. On to 09/29/16 for SVR 12.

Offline KimInTheForest

  • Member
  • Posts: 1,972
  • Believe in yourself
Re: Harvoni, After Treatment, Blood Work
« Reply #1 on: August 04, 2016, 02:17:12 pm »
Good Luck Jimmy! I hope you achieve SVR4 & SVR12! But if not, there are new drugs (Epclusa for example) that may get around the resistance issue.

Kim :)
Logged
Kim Goldberg (Nanaimo, BC)
1970s: Contracted HCV (genotype 3a)
2015: Cured with Harvoni + ribavirin (12 weeks)
MY STORY: https://pigsquash.wordpress.com/2016/01/28/undetectable-my-hep-c-story/

Offline JimmyK

  • Member
  • Posts: 18
Re: Harvoni, After Treatment, Blood Work
« Reply #2 on: August 04, 2016, 02:24:13 pm »
Thanks Kim!
Yes I hope so as well. That would be fantastic if the 12 weeks worked. The fact that I was responding well throughout treatment makes it hopeful. Also with regard to compliance I was extremely adamant. Every dose, all 84 pills were taken on an alarm set for 5:55am. Did not once so much as get to 5:57 without the Harvoni and the Omeprazol down the hatch.  ;)

JimmyK
Logged
Gen 1a HCV PCR Q 3880000, ALT 94 AST 58, F2
Tx 1 Viek/Rib x 12 SOT 10/15/15 Breakthrough_Treatment Stopped 12/29/15

Tx 2 Harvoni x 12, SOT 04/15/16, EOT 07/07/16, UND week 4 and 12. EOT + 4 Weeks 08/04/16 will repeat HCV RNA to determine status due to NS5A and NS3 findings at EOT TX1 12/29/15. (M28T and Q80K,D168Y)
Considered an "interesting" case. Update EOT + 4 Weeks HCV RNA came back UND. On to 09/29/16 for SVR 12.

Offline Mugwump

  • Member
  • Posts: 778
  • My number of posts means nothing, piscor ergo sum!
Re: Harvoni, After Treatment, Blood Work
« Reply #3 on: August 04, 2016, 07:04:34 pm »
Your chances of being svr are very good. From what I am reading if you clear at 12 weeks then most likely 24 week treatment will just put the icing on the cake. Even with the rav you have if you did clear immediately then most likely you are home free.

If you are not clear then I would start a civil action against the insurance company that interrupted the course of medication. Stick it to them as hard as you can and go for a huge sum to teach them some manors.


Logged
Caution shameless self promotion below :-)
https://www.hepmag.com/article/eric-reesor-27742-782589663
DING DONG MY DRAGON (HCV) IS FINALLY DEAD!

Offline JimmyK

  • Member
  • Posts: 18
Re: Harvoni, After Treatment, Blood Work
« Reply #4 on: August 04, 2016, 07:22:24 pm »
Hiya Mug, thanks for the response.
I am hopeful and things will turn out as they are supposed to.

Regarding civil action against the Insurance Company, I am not entertaining such thoughts. It does not go well with my beliefs.

That said, I am pretty sure if I do fail, I will not have to worry about them being very cooperative in round three with the Dragon.  I have some pretty damaging written evidence in the initial denial letter. To be honest it is kind of like the old school "E" Tickets at Disneyland. LOL

JimmyK
Logged
Gen 1a HCV PCR Q 3880000, ALT 94 AST 58, F2
Tx 1 Viek/Rib x 12 SOT 10/15/15 Breakthrough_Treatment Stopped 12/29/15

Tx 2 Harvoni x 12, SOT 04/15/16, EOT 07/07/16, UND week 4 and 12. EOT + 4 Weeks 08/04/16 will repeat HCV RNA to determine status due to NS5A and NS3 findings at EOT TX1 12/29/15. (M28T and Q80K,D168Y)
Considered an "interesting" case. Update EOT + 4 Weeks HCV RNA came back UND. On to 09/29/16 for SVR 12.

Offline brie41

  • Member
  • Posts: 191
Re: Harvoni, After Treatment, Blood Work
« Reply #5 on: August 05, 2016, 07:55:08 pm »
Hi Jimmy,

  I think it is terrible that you had to go through an appeal and it cost you the chance to stay on course with your treatment.  I will be keeping good thoughts for you that you will stay undetected and hopefully you can put this all behind you.   I was only allowed 8 weeks of Harvoni and I also took my pill every night at 6:30.   I was determined to do everything right and give myself the best chance.  Hang in there.  Brie
Logged
Diagnosed  HCV, 1A 2006
Viral load 6 million
Ast/Alt always in the 20's
F0-F1, never changed
Treatment naive, started 8 week Harvoni 3/15/16
4 and 8 week labs undetected
6 week eot labs undetected
13 week eot UNDETECTED!

Offline Philadelphia

  • Global Moderator
  • Member
  • Posts: 1,157
  • It only looks like I know what I'm doing
Re: Harvoni, After Treatment, Blood Work
« Reply #6 on: August 06, 2016, 12:34:51 am »
My fingers will be crossed for you.
Logged
CURED SVR24  Class of 2015
Wk 12 post EOT 30.11.15: ALT 14 AST 22 GGT 22 VL UND
Week 19 07.08.15: ALT 17 AST 23 GGT 25
Week 12 18.06.15: ALT 21 AST 23 GGT 28
Week 8 25.05.15: ALT 23 AST 27 GGT 30 VL UND
Week 4 20.04.14: ALT 30 AST 36 VL 40
Treatment start 23.03.15: ALT 137 AST 185 VL 342,600
Cirrhosis Child-Pugh A, Genotype 1a - Viekira Pak + riba 24 weeks
Total failure interferon/ribavirin/boceprovir Mar 2013
https://www.hepmag.com/blogger/grace-campbell

Offline JimmyK

  • Member
  • Posts: 18
Re: Harvoni, After Treatment, Blood Work
« Reply #7 on: August 06, 2016, 09:19:26 am »
Thanks friends, I appreciate all the kind words and thoughts.

JimmyK
Logged
Gen 1a HCV PCR Q 3880000, ALT 94 AST 58, F2
Tx 1 Viek/Rib x 12 SOT 10/15/15 Breakthrough_Treatment Stopped 12/29/15

Tx 2 Harvoni x 12, SOT 04/15/16, EOT 07/07/16, UND week 4 and 12. EOT + 4 Weeks 08/04/16 will repeat HCV RNA to determine status due to NS5A and NS3 findings at EOT TX1 12/29/15. (M28T and Q80K,D168Y)
Considered an "interesting" case. Update EOT + 4 Weeks HCV RNA came back UND. On to 09/29/16 for SVR 12.

Offline AussieRosa

  • Member
  • Posts: 226
Re: Harvoni, After Treatment, Blood Work
« Reply #8 on: August 08, 2016, 08:40:10 am »
Best of luck, Jimmy. You've had a really unfair experience and I admire your attitude towards it all.
Logged
Gt 1a
contracted 1983
Fibroscan 6.1
Treatment naive
VL 2.97M
ALT 38
AST 47
Started Viekira Pak + Ribavirin Tues 19th Jan 2016
Week 4: VL Undetected!
March 5th Ribavirin dose reduction to 800mg from 1000mg
EOT April 11th 2016. VL Not Detected
12 Weeks post EOT: SVR12. Cured with a capital C!!
6 months post EOT: Undetected :-)

Offline JimmyK

  • Member
  • Posts: 18
Re: Harvoni, After Treatment, Blood Work
« Reply #9 on: August 08, 2016, 08:55:50 am »
Greetings and thanks for the kind words.

I actually consider myself very fortunate. Lot's of folks don't really get the proper chance to treat and that is very sad indeed.

I have been looking at the new triple and it looks like a pretty good clean up for those who fail DAA treatment.

https://hepatitiscnewdrugs.blogspot.com/2016/04/ilc2016-sofosbuvirvelpatasvir-and.html

This one is specific for prior failures and at 99% looks pretty good. Shoot SVR12 is 99.9% and nothing is 100% so no worries here. If I do fail I will rest up until Jan 2017 probably. We shall see.

Thanks again!

JimmyK
Logged
Gen 1a HCV PCR Q 3880000, ALT 94 AST 58, F2
Tx 1 Viek/Rib x 12 SOT 10/15/15 Breakthrough_Treatment Stopped 12/29/15

Tx 2 Harvoni x 12, SOT 04/15/16, EOT 07/07/16, UND week 4 and 12. EOT + 4 Weeks 08/04/16 will repeat HCV RNA to determine status due to NS5A and NS3 findings at EOT TX1 12/29/15. (M28T and Q80K,D168Y)
Considered an "interesting" case. Update EOT + 4 Weeks HCV RNA came back UND. On to 09/29/16 for SVR 12.

Offline JimmyK

  • Member
  • Posts: 18
Re: Harvoni, After Treatment, Blood Work
« Reply #10 on: August 10, 2016, 10:38:38 am »
Greetings,

I have an extremely shocking update regarding EOT + 4 Weeks HCV RNA Results. I remain UND.

I can honestly say I was not expecting this sort of news but am getting cozy in the 97% category for SVR 12.

All Glory, Honor and Thanks be to God.

Regards
JimmyK
Logged
Gen 1a HCV PCR Q 3880000, ALT 94 AST 58, F2
Tx 1 Viek/Rib x 12 SOT 10/15/15 Breakthrough_Treatment Stopped 12/29/15

Tx 2 Harvoni x 12, SOT 04/15/16, EOT 07/07/16, UND week 4 and 12. EOT + 4 Weeks 08/04/16 will repeat HCV RNA to determine status due to NS5A and NS3 findings at EOT TX1 12/29/15. (M28T and Q80K,D168Y)
Considered an "interesting" case. Update EOT + 4 Weeks HCV RNA came back UND. On to 09/29/16 for SVR 12.

Offline AussieRosa

  • Member
  • Posts: 226
Re: Harvoni, After Treatment, Blood Work
« Reply #11 on: August 16, 2016, 02:34:39 am »
Wonderful news, JimmyK. You must be so relieved and thankful. After all you've been through this has been a long time coming. Hopefully you'll be able to relax into the knowledge that you are, for all intents and purposes, cured now!
Logged
Gt 1a
contracted 1983
Fibroscan 6.1
Treatment naive
VL 2.97M
ALT 38
AST 47
Started Viekira Pak + Ribavirin Tues 19th Jan 2016
Week 4: VL Undetected!
March 5th Ribavirin dose reduction to 800mg from 1000mg
EOT April 11th 2016. VL Not Detected
12 Weeks post EOT: SVR12. Cured with a capital C!!
6 months post EOT: Undetected :-)
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