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Author Topic: Another Harvoni Failure  (Read 87116 times)

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Offline mario555

  • Member
  • Posts: 226
Re: Another Harvoni Failure
« Reply #100 on: July 06, 2015, 08:55:45 pm »
Thanks Pappy (feels weird to say that at my age..). I will not get a test result for my viral load before the end of August. This will be a full 16 weeks after EOT. I only have my 'instinct' as you mention and I think I am better but not by a noticeable amount. My liver enzymes were normal 9 weeks after EOT and I still 'piss clear'. Those are my only guides for now.
For the ones who relapsed, were your enzymes high when you learned of your relapse?
I notice I'm not too good with the wait period...
Logged
60 years old. Likely infected 1975. Geno 1a
F4  8 millions VL,  AST 140  ALT 140
Generally in good health except problems are creeping up rapidly!
2 failed attempts Inf 2000 and Inf-riba 2010
Harvoni 24 weeks
Start 11/13/2014   EOT 4/27/2015
VL2 - UND
VL4 - UND (may 25)
VL12 - UND
VK24 -  UND
Hopefully cured forever!

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Another Harvoni Failure
« Reply #101 on: July 06, 2015, 08:57:36 pm »
Hi Mantrasonica

So sorry to hear of your relapse. I relapsed on Sov Oly 12 week treatment last year after being a null responder multiple times. I was so hopeful that treatment would work but was not to be.

Just wondering if you also treated with ribavirin?

I just finished 24 weeks of harvoni but my doctor later added ribavirin so I was on Harvoni and Riba for 15 of the 24 weeks. Per the AASLD Recommendations for Testing, Managing, and Treating Hepatitis C they are saying

"Patients with HCV genotype 1 or 4 with decompensated cirrhosis (moderate or severe hepatic impairment; Child Turcotte Pugh [CTP] class B or C) should be referred to a medical practitioner with expertise in that condition (ideally in a liver transplant center).

Rating: Class I, Level C

Recommended regimens for patients with decompensated cirrhosis (moderate or severe hepatic impairment; CTP class B or C) who may or may not be candidates for liver transplantation, including those with hepatocellular carcinoma. These regimens should be used only by highly experienced HCV practitioners.

Daily fixed-dose combination ledipasvir (90 mg)/sofosbuvir (400 mg) and RBV (initial dose of 600 mg, increased as tolerated) for 12 weeks is recommended for patients with decompensated cirrhosis.

Rating: Class IIb, Level C

For patients with decompensated cirrhosis and anemia or RBV intolerance, daily fixed-dose combination ledipasvir (90 mg)/sofosbuvir (400 mg) for 24 weeks is recommended.

Rating: Class IIb, Level C

For patients with decompensated cirrhosis in whom prior sofosbuvir-based treatment has failed, daily fixed-dose combination ledipasvir (90 mg)/sofosbuvir (400 mg) and RBV (initial dose of 600 mg, increased as tolerated) for 24 weeks is an alternative regimen.

Rating: Class IIb, Level C"

Personally when I relapsed last year I felt no different before during or after treatment up until my relapse my only clue was when I got my liver function test back before the 12 week post viral load test and my liver enzymes were above normal again.

As far as Pappy's comment about feeling hep c "bite" I had no such occurrence I had no instinct I had no clue about my relapse. Really the only hep c symptom I have is liver cirrhosis and symptoms to liver cirrhosis and those are not going away any time soon.

I was still not detected at 4 weeks post my 12 week post is coming up on July 27th three weeks so we will see how it goes for me soon.
Logged
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 mario555

  • Member
  • Posts: 226
Re: Another Harvoni Failure
« Reply #102 on: July 06, 2015, 09:19:23 pm »
Lynn K my sister in arms! You have a nice touch with words! Thanks for the hint. Mantrasonica, although what you are going through is the shits, at least you can count on a number of new medicine coming up very soon.
If I 'my ever in this situation again, I would not choose a Sofosbuvir based treatment (except for a 8 weeks failure who goes for 24 weeks). Good luck with your future retreatment.
Logged
60 years old. Likely infected 1975. Geno 1a
F4  8 millions VL,  AST 140  ALT 140
Generally in good health except problems are creeping up rapidly!
2 failed attempts Inf 2000 and Inf-riba 2010
Harvoni 24 weeks
Start 11/13/2014   EOT 4/27/2015
VL2 - UND
VL4 - UND (may 25)
VL12 - UND
VK24 -  UND
Hopefully cured forever!

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Another Harvoni Failure
« Reply #103 on: July 06, 2015, 10:00:30 pm »
Hi Mario!

Just for us fans of numbers my EOT 12 weeks Sov/Oly last year liver functions result 6/11/14

ALT (GPT) <33 U/L 29
AST(GOT) 0 - 50 U/L 25


My 12 week post liver functions I received just before I got my viral load relapsed results
9/3/14

ALT (GPT) <33 U/L 56
AST(GOT) 0 - 50 U/L 45

When I saw this result it definitely got my attention that there could be a problem which was confirmed a few days later when I received my viral load test result.

9/3/14

HCV RNA RT-PCR, QT  IU/mL 2422260
HCV LOG 10   log10 IU/mL 6.384

Hope to see better results in 3 weeks and I will be looking for yours most def!
Logged
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 pappy

  • Member
  • Posts: 22
Re: Another Harvoni Failure
« Reply #104 on: July 06, 2015, 10:04:47 pm »
Quote from: mario555 on July 06, 2015, 08:55:45 pm
Thanks Pappy (feels weird to say that at my age..). I will not get a test result for my viral load before the end of August. This will be a full 16 weeks after EOT. I only have my 'instinct' as you mention and I think I am better but not by a noticeable amount. My liver enzymes were normal 9 weeks after EOT and I still 'piss clear'. Those are my only guides for now.
For the ones who relapsed, were your enzymes high when you learned of your relapse?
I notice I'm not too good with the wait period...

Your vl and other stated enzymes including your age are very similar to mine have faith sooner or later it gonna get beat .
Logged

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Another Harvoni Failure
« Reply #105 on: July 06, 2015, 10:21:54 pm »
Hi Pappy

Do you have liver damage like Mario and I do? We both have cirrhosis
Logged
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 Katie

  • Member
  • Posts: 784
Re: Another Harvoni Failure
« Reply #106 on: July 06, 2015, 10:29:43 pm »
Just my 2 cents...I had insomnia for over 10 years and was lucky to sleep 3 nights a week, more than 3 or 4 hours.  I took a prescribed sleep aid only when I had an important day coming up as none of that stuff is good for a compromised liver.  I was a walking zombie on many days.  With my 2nd Harvoni pill I slept, and I started dreaming again and felt rested and energized.  Many of my friends said my insomnia was normal as we aged, but I didn't believe them, and I was right. It definitely was the HepC. I am 17 weeks post treatment (which was successful) and I am still sleeping like a baby and am so grateful.  I am still having some weakness and fatigue which happened after I finished treatment.  This seems to happen to quite a few of us, but eventually everyone ahead of me is reporting regaining their energy and endurance.  Our bodies have undergone so much so we need to be patient and allow healing.

Waiting is the most difficult part.  I am one of those who was detected at EOT and the wait for my next test was horrible.  I kept feeling better and then found articles where some were clearing after time passed so I was hopeful.  I cleared at 8 weeks and maintained UNDETECTED status at week 16.  I feel so blessed.

Good luck to all of you,

Katie
Logged
1 year post treatment blood work done and I am FREE!
GT 1a (4/1/2016)
Dx 2005
VL 2.6 million (fluctuated from 2-16 million during the 9 years)
Started Tx 12/4/2014 for 12 weeks
4 week blood work  Detected 59 IU/mL
EOT Detected <12 IU/mL
7.5 weeks post  Undetected
16 week post Undetected
24 WEEK POST UNDETECTED (I made it)
Waiting to feel good but feeling blessed!
12 month post treatment.  All blood work absolutely perfect! VL, as expected UNDETECTED!

Offline HHburme

  • Member
  • Posts: 117
  • Harvoni start 12/13/14 12wks UD/24wk DET
Re: Another Harvoni Failure
« Reply #107 on: July 07, 2015, 10:38:57 am »
I was undetetected from 4 weeks on Harvoni until my final labs at 24 weeks, 12 weeks post treatment. I was tx naïve and had Harvoni for 12 weeks, 84 days. We will conquer this beast soon. I was sent for resistance testing after relapsing, not positive it has something to do with why I failed. I'm sharing the results for everyone.

 LEDIPASVIR RESISTANCE
 PREDICTED

 HCV NS5a SUBTYPE
 1a

 OMBITASVIR RESISTANCE
 PREDICTED

 Mutations Detected: M28A, Q30R

 DACLATASVIR RESISTANCE
 PREDICTED

 I'm thinking maybe this is why I did not obtain SVR on Harvoni. I have not spoken with the doctors yet as I just received these results.

 Fight the Good Fight !!
 John
Logged
infected age 19, blood transfusion 1977, detected 2003  GT 1a, Harvoni relapse 06/15, Clinical Trial Study for SOF/VEL GS-9857 start 02/16. SVR12 Cured 08/16

Offline mario555

  • Member
  • Posts: 226
Re: Another Harvoni Failure
« Reply #108 on: July 07, 2015, 11:11:55 am »
Too bad they didn't test for resistance BEFORE giving you 12 weeks. 24 weeks would most probably have done the job! Thank you for giving us a look at those tests, I didn't know about them!
Good luck to you!
Logged
60 years old. Likely infected 1975. Geno 1a
F4  8 millions VL,  AST 140  ALT 140
Generally in good health except problems are creeping up rapidly!
2 failed attempts Inf 2000 and Inf-riba 2010
Harvoni 24 weeks
Start 11/13/2014   EOT 4/27/2015
VL2 - UND
VL4 - UND (may 25)
VL12 - UND
VK24 -  UND
Hopefully cured forever!

Offline pappy

  • Member
  • Posts: 22
Re: Another Harvoni Failure
« Reply #109 on: July 07, 2015, 11:37:32 am »
Quote from: Lynn K on July 06, 2015, 10:21:54 pm
Hi Pappy

Do you have liver damage like Mario and I do? We both have cirrhosis
 

Yes compensated called child pugh score for bilirubin of 2.4 on last test
Logged

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Another Harvoni Failure
« Reply #110 on: July 07, 2015, 02:42:50 pm »
Child Pugh A B or C do you know your MELD?

I am Child A,MELD 8 diagnosed with cirrhosis in Jan 2008. I was F3 on previous biopsy in 2003. My bilirubin is still in normal range 0.8 but my INR is 1.1 so that raises my MELD.

I have some portal hypertension evidenced by esophageal varicies that required banding in 2012 which required 4 sessions of banding to get rid of all the varicies and now have annual upper endoscopies to check to make sure they haven't returned.
Logged
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 pappy

  • Member
  • Posts: 22
Re: Another Harvoni Failure
« Reply #111 on: July 08, 2015, 01:23:06 am »
Sorry not much into stats but glad i'm not getting any other problems yet  :-X . As for some people testing for medicine resistance after a failed attempt to cure you are always going to be resistant . I went from a 1.2 million VL before failing to 7.5 million VL after failing harvoni . The good news is many have success , bad is try and fail and often you are worse . I wish everyone good luck .
Logged

Offline Bob V

  • Member
  • Posts: 231
Re: Another Harvoni Failure
« Reply #112 on: July 08, 2015, 10:10:36 am »
Quote from: pappy on July 08, 2015, 01:23:06 am
Sorry not much into stats but glad i'm not getting any other problems yet  :-X . As for some people testing for medicine resistance after a failed attempt to cure you are always going to be resistant . I went from a 1.2 million VL before failing to 7.5 million VL after failing harvoni . The good news is many have success , bad is try and fail and often you are worse . I wish everyone good luck .
-------
pappy
Pre tx this was one thing I did think about since I was HepC stable. If I failed tx would I be worse off.....
Logged
Male 64
Dx hep non AB 1972, Hep C 1991
GT 1A
VL 3.7m (pre tx)
Liver B 1992, unremarkable
Liver ultrasound 2014, normal
Treatment Interferon 90's x2 failed
Started Harvoni 12/08/2014 (12wks)
Finished Harvoni  3/1/15
5wk lab detected <15
8wk lab UND
EOT lab UND!
12wk post lab UND!
24wk post lab UND!
58wk post lab UND!

Offline pappy

  • Member
  • Posts: 22
Re: Another Harvoni Failure
« Reply #113 on: July 08, 2015, 12:08:39 pm »
People are different and results differ . The medications out now are mostly successful and with few side effects ,  better to go get the best all out answer then trust the lord .
Logged

Offline GLCII

  • Member
  • Posts: 127
Re: Another Harvoni Failure
« Reply #114 on: July 08, 2015, 12:10:20 pm »
Quote from: HHburme on July 07, 2015, 10:38:57 am
I was undetetected from 4 weeks on Harvoni until my final labs at 24 weeks, 12 weeks post treatment. I was tx naïve and had Harvoni for 12 weeks, 84 days. We will conquer this beast soon. I was sent for resistance testing after relapsing, not positive it has something to do with why I failed. I'm sharing the results for everyone.

 LEDIPASVIR RESISTANCE
 PREDICTED

 HCV NS5a SUBTYPE
 1a

 OMBITASVIR RESISTANCE
 PREDICTED

 Mutations Detected: M28A, Q30R

 DACLATASVIR RESISTANCE
 PREDICTED

 I'm thinking maybe this is why I did not obtain SVR on Harvoni. I have not spoken with the doctors yet as I just received these results.

 Fight the Good Fight !!
 John

If I'm understanding this correctly, they can pretty much predict, with those tests, if a person is likely to clear or not clear the virus using the Harvoni Tx. How much time, money & mental stress could be avoided if they used those tests prior to treating?

I'm Sorry to hear about this John (HHburme)
Logged
Pre Tx (VL 12043488) ALT 52/ AST 39
Harvoni Start Date 03/12
2 Week in Tx Results HCV RNA Detected, less than 15 IU/mL. ALT 19 / AST 19
4 Weeks in Tx Results HCV RNA Not detected. ALT 21 / AST 18
12 Week in Tx Results HCV RNA Not detected. ALT 17 / AST 19
--------------------------------------------------------------
Post 12 Week EOT Tx ALT 19/ AST 19 (Undetected)
Post 24 Week EOT Tx ALT 19/ AST 15 (Undetected)

Offline pappy

  • Member
  • Posts: 22
Re: Another Harvoni Failure
« Reply #115 on: July 08, 2015, 12:43:23 pm »
Those drugs are found in Viekira Pak not harvoni , his doctor is trying to avoid Viekira pak . The insurance company will prefer the cheaper option .
Logged

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Another Harvoni Failure
« Reply #116 on: July 08, 2015, 02:02:17 pm »
Harvoni is a combo medicine consisting of Sovaldi and Ledipasvir.

Perhaps the resistance was a result of treatment curious if it existed prior. I do know those tests are normally not done except in the setting of a clinical trial

Best to all
Lynn
Logged
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!
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