stage 3

[marivirginia]

Hello All,

Today was my second visit to see a new doctor. I have hep c, 1a, ct and treated 2 times the last with triple therapy in 2012. Last visit I was told they were testing to see if my body made mutated strands that are resistant to sovaldi and olysia. Today they told me instead of that test they did the fibrascan and no test for mutation. They reported I am a stage 3 liver damage. Should I be worried about this? There is nothing I can do about the testing mix up. Does anyone know if you've been treated before, do you always have resistant strands that make you ineligible for sovaldi and olysia?
Thanks!
Mary

[Mike]

There is a mutation (Q80k polymorphism) that reduce the chance of SVR (cure) by 20-25% in type 1a infections. I haven't read that this would make you ineligible for treatment. However, if this mutation is present, your chance of a SVR are significantly reduced.

In fact, when present, and, in combination with specific geneotype, viral load, age, liver damage, prior nonresponder, may reduce the chances of a SVR by 50% or more.

Liver damage is graded on a 0-4 scale. A grade 3 indicates moderately severe fibrosis. Grade 4 indicates cirrhosis, which has to be confirmed with a liver biopsy. (please note I'm not a doctor, and you should discuss this with your medical provider)

Best wishes, Mike

[marivirginia]

Thanks Mike..I actually have responded to both tx regimens but relapsed. So I will wait to see if I have this poly business. Is that one of many mutations? Can one not have that particular mutation? I know you are not in the medical profession, but you know more that me!!!

[Mike]

Yes. There are many mutation within a specific genotrype (i.e., genotypes 1, 2, 3, 4, 5 & 6 ). In this regard, common mutations for  genotpe 1 would be 1a and 1b. These subgroups can also have mutation. Genotype 1a can have the Q80k polymorphism mutation, which impacts treatment outcomes.

Researchers are currently studying these mutations, in order to 'tailor' specific treatment protocols to the exact genotype and mutation variant.

Regarding failed prior treatment: If an individual relapses from previous treatment, meaning a failed SVR at 12 or 24 weeks post treatment, the presence of mutation may be clinically indicated.

The good news: this is the golden era for Hep-C treatment, and the current treatments available, and the those soon to come, are so effective, mutation wont even matter!

Time to slay this dragon!

Best wishes, Mike

[lporterrn]

Hi Mary,
I am pretty sure that Q80K only applies to Olysio. I don't think there are any resistant strains that are being used for Sovaldi-related treatment decisions. Did your doc recommend any treatment?

[marivirginia]

Is it sovaldi and simeprevir that is the next big cure?

[lporterrn]

Sort of. In October, Sovaldi and ledipasvir are expected to be approved, making them the likely leaders for geno 1. Currently, Sovaldi is a better choice for 1a, but in patients with cirrhosis, Sovaldi and Olysio are often being used. I don't know what they would recommend for stage 3, but waiting for Sovaldi and ledipasvir seems like a reasonable option - so does treatment now. What is your doctor recommending?

[marivirginia]

He is recommending tx with Sovaldi and Olysio. Perhaps because I am almost 62? In 2008 I was stage 2..who knows..I would just like to get rid of this beast. I appreciate your help. What is your story?

[marivirginia]

Lucinda,
I see you are a nurse. Thanks for the information!
Mary

[lporterrn]

Hi Mary,
My story is a long one, but basically I have been working in this field since 1998 and wrote two books about it. I contracted hep C in 1988 and am now cured (Sovaldi and ledipasvir). You can read my story at Hep Stories.http://www.hepmag.com/articles/lucinda_porter_2846_11259.shtml Perhaps you want to send yours in too?

Keep in touch.

[marivirginia]

Lucinda,

Your story made me cry. It is a gift, but I am now done with this gift. It has taught me all that you spoke of. Thanks for the good work you do. I am anxious to begin therapy with the drugs you took. I am waiting for the Q80Kpolymorphism mutation results to see if I can start with the current off brand cure. I just want to keep my stage at 3 if possible until the real cure is on market. I will keep you posted and consider writing my story.
Mary