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Author Topic: Ribavirin or no Ribavirin  (Read 7876 times)

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Offline Else

  • Member
  • Posts: 523
  • Appeal, appeal, and appeal again!
Re: Ribavirin or no Ribavirin
« Reply #1 on: March 24, 2015, 08:48:18 pm »
Thank you for posting that!  I have concerns about Ribavirin's side-effects.  Namely, the pruritus.  I had third trimester chloestasis when pregnant with my son 15 years ago.  Bad during day, unbearable at night.  It was unbearable to the point of talking with my doctor about inducing labor early.  No lotion could touch it.  Just grateful that it was winter time - rubbing snow on myself helped a tiny bit.

So when a side-effect says "pruritus", I seriously shudder.  :(
F/53 yr
diagnosed 1995
Genotype 1a
ALT: 58 AST: 39 ALK: 105
Viral load 4,201,950 IU/ml
Fibroscan 6.5 (F1-F2) Fibrosure 0.36 (F1-F2)
Treatment-naive
After 3 denials, finally approved!
Harvoni 12 wks - start date 9/15/15
4 wk labs 10/14/15
ALT: 12 AST: 16 ALK: 85
HCV Not Detected!!!
8 wk labs 11/10/15
ALT: 13  AST: 15  ALK: 77
12 wk (EOT!) labs 12/8/15
ALT: 11 AST: 15 ALK: 78
HCV Not Detected!!!
10wk posttx labs 2/11/16
ALT: 22 AST: 17 ALK: 61
HCV Not Detected!! SVR10!!!
SVR10 (99.7% Cured!!!)

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,544
  • Get tested, get treated, get cured, fight Hep c!
Re: Ribavirin or no Ribavirin
« Reply #2 on: March 25, 2015, 04:22:11 am »
might be a way to argue in favor of Harvoni vs Viekira Pak make sure your doctor knows you have this previous issue.

With Harvoni you should not need Riba but with Viekira Pak it is required for GT 1a's

Good luck
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline charly8

  • Member
  • Posts: 113
Re: Ribavirin or no Ribavirin
« Reply #3 on: March 25, 2015, 08:36:30 am »
I suspect that the Ribavirin will help reduce the resistance of the virus that may occur when using direct antivirals and probably does not much more. 

This is due to the mechanism of action of the ribavirin.   Ribavirin induces mutations in RNA-dependent replication in RNA viruses. Such hypermutation can be lethal to RNA viruses especially when used with other antivirals.

So basically they way it works is this:

The virus in its natural state is mostly called "wild type" virus.  These wild types are typically very weak strains.  The virus can mutate a resistance to interferon or antivirals but the riba knocks it back down into the wild type again so the the mutations can not get a foothold. 

This is shown in the literature where the 12 week harvoni arms w/o riba had relapsers with NS5A resistance, where the 12 wee harvoni arms with riba did not have NS5A resistance. 

I suspect that 24 weeks of Harvoni is very potent and is superior to 12 weeks of harvoni with riba due to the fact that even the most resistant virus can not hide for 24 weeks from the strong harvoni direct antivirals.

« Last Edit: March 25, 2015, 08:38:46 am by charly8 »
1a, VL  1.05 Mil, ALT 47
Fibrosure F3 December 2014
Fibroscan F0-F1 March 2015
1995 INT & RYB -non-responder
2007 PEGIN & RYB 72 weeks tx - partial responder relapsed
1/23/15 Started Harvoni 12 weeks, EOT 4/17
2 week blood work -  <15 Und. (ALT 25)
4 week blood work - <15 Und. (ALT 29)
2/20/15 added RYB (4 weeks into 12 of tx)
8 week blood work - <15 Und. (ALT 23)
(EOT) 12 week blood work - <15 Und.
4wk POST tx VL - Und. (ALT16, AST 17)

 


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