Virus back with a vengeance

[Pete]

I posted back in July that my 4 week post Harvoni (12 weeks tx) had indicated the virus was on the rebound.  I just got back my post 12 week labs and viral load is almost back to where it was prior to staring tx.  My ALT / AST are now in the 300's.  I've always been just slightly high out of range. 

My NP stated that more than 8 weeks of Harvoni can cause the virus  to build up a resistance to Harvoni (if a relapse occurs), and that a second round of Harvoni is not showing good results even for a 24 week tx period.  So that doesn't sound like an option.

She suggested the 2 following tx options for me, and would help me with the approvals if I decided to give it another shot.

Viekira pak with Riba x 24 weeks
Daklinza with Sovaldi with or without Riba x 24 weeks.

I'm not certain if either of these have a good track record with geno 1a.  Any info that might help me make a decision would sure be welcome. 

Thanks and my best to all,
Pete


 

[gnatcatcher]

Pete, I'm very sorry that you are in this predicament. Based on what I've read in some other threads concerning someone in whom Harvoni didn't permanently clear the virus, resistance is a real possibility. I am under the impression that it can be tested for, but the tests aren't cheap (7k according to Dennis, who goes by tmf2 and is also having to decide what to do next). The current AASLD Guidelines for retreatment can be found here: http://www.hcvguidelines.org/full-report/retreatment-persons-whom-prior-therapy-has-failed
   I hope others who know more will see this thread and chime in, but meanwhile you at least have the link to an authoritative source.
   Best wishes with your decision,
Gnatty

[katmakiah]

Sorry to hear this. I just joined the club. My 12 weeks post labs showed 1.5 million VL and ALT and AST 160 and 102. I'm currently of the opinion that as my liver began to heal from possible cirrhosis, definite advanced bridging fibrosis, that virus caught in scar tissue got loose and began to replicate again. I shared this opinion with Gilead's Medical Information line and she said that it made sense to her, but she could not say absolutely that is what happened. She was very nice about it.

The number I called is 800-445-3235, opt 2, then opt 6.

We also have a group for relapse on Facebook.
https://www.facebook.com/groups/871606559543534/

The purpose is to keep each other informed.

You are welcome.

[Pete]

I tried to get 24 weeks, but no dice.  I was tx naive and apparently those are the rules cirrhosis or not.   Still pondering next steps...

Thanks for the link, I'll check it out.  Thanks for the FB invite, but I don't have an active account. 

Regards,
Pete

[Lynn K]

One of the meds in Viekira pak is in the same class as the ledipasvir component of harvoni so Viekira Pak is not an option. If you don't have cirrhosis waiting for better meds is the current recommendation. If you can get Daklinza with Sovaldi with or without Riba x 24 weeks (personally I would go with the Ribavirin if you can handle it) You can look for a clinical trial as well.

https://clinicaltrials.gov/

sorry to see you have relapsed hang in there

Good luck
Lynn

[tmf2]

Sorry to hear this Pete I'm in the same boat with Cirrhosis and had resistance confirmed by the blood test. (NS5A and Q80K). So as Lynn states ledipasvir  will not be a viable option, My insurance company prior to my screening denied 24 wks of Harvoni or the Viekira Pak . Most of the trials for  Harvoni failures are using Sovaldi with another clinical med as a combo. Daklinza with Sovaldi might very well be the answer. I have an appointment with a liver specialist in Seattle in Dec hopefully I'll get some answers and hopefully start another treatment. I see people posting about being frightened of starting treatment I'm totally opposite I frightened if I don't. I asked the Docs assistant in Seattle about Harvoni failures she stated there seeing a little more then a few for what its worth. I thought I was the only one as I'm see so many successes here. So hopefully they will develop something for us that relapse….my clock is ticking with the Cirrhosis.


Dennis