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Author Topic: relapse after 1 year  (Read 75662 times)

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Offline audreywald

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  • Posts: 33
relapse after 1 year
« on: June 07, 2016, 12:11:59 pm »
I took Harvoni  and it ended last year, June 17th. I had no viral load from 5 weeks in. At 6 months I was still clear. The Dr's office said I was still clear and I would not be tested again unless I requested it. Well, I did request it. And after a year my viral load came back. Is this it? I've had this dragon around 40 years so my question is this: Has this happened to anyone else? Has anyone heard of any newer drugs?
Does this mean I am probably going to die of this illness?

Offline gnatcatcher

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  • Posts: 1,372
Re: relapse after 1 year
« Reply #1 on: June 07, 2016, 12:34:40 pm »
Audrey, I'm so sorry that you have to deal with the dragon again, but this is not a death sentence. There are quite a few new treatments in the pipeline (others know the details; I trust they'll chime in). Your liver specialist is likely to recommend resistance testing to figure out what the best course of action will be.
9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline KimInTheForest

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  • Believe in yourself
Re: relapse after 1 year
« Reply #2 on: June 07, 2016, 12:35:03 pm »
So sorry to hear you relapsed, Audrey!  :(

That is very unusual after reaching SVR24. Is there any chance it could be a lab error? Was it a high viral load, in the millions? Or low, in the hundreds? If it is very low, I would definitely want that retested.

As for new drugs, I am pretty sure there is now something available for treating Harvoni relapsers. But your doctor would probably want to test you first to see if you are resistant to anything, to see what new drug would be most likely to work on you.

Don't give up. I am sure you will be able to clear the virus. There are new developments weekly and monthly where Hep C treatments are concerned. It is a Gold Rush right now for the developers of Hep C cures.

kim
« Last Edit: June 07, 2016, 02:35:18 pm by KimInTheForest »
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 dragonslayer

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  • Posts: 873
Re: relapse after 1 year
« Reply #3 on: June 07, 2016, 02:11:47 pm »
Boy, that is some Horrible news... Its so extremely rare for this to happen after achieving SVR at the key checkpoints, I know how everybody feels reading this; it instantly makes every one of us feel instantly vulnerable regardless of our SVR status.

Its so rare, any chance of lab error, as Kim mentions?   Anything which could cause reinfection?  Relapse in this time frame is almost non existent..

Think about it..   HCV must replicate or die, basically... Replication manifests itself in a rapidly increasing Viral Load.  HCV is not supposed to 'hide'  like HIV does.  So, to have 6 months of Undetecteds, and then to relapse at a year, makes one wonder about the mechanism that could cause this.  How is it possible for one to have no detectable HCV rna at 6 mos, and then all of a sudden to develop one?  Where's it been for all this time? If it were vital, it would have shown at 6 mos or before.   Very confused....

Hoping that this was a lab error; please get back to us with updates, and with your recent viral load result.

« Last Edit: June 07, 2016, 02:17:59 pm by dragonslayer »
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline Lynn K

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Re: relapse after 1 year
« Reply #4 on: June 07, 2016, 02:14:38 pm »
Did you have a HCV RNA by PCR test or is it possible the lab may have done the antibody test?

If it was the antibody test we will always test positive for the antibodies to hep C but antibodies are not the virus. I am hoping your lab ran an antibody test in error or your doctor accidentally requested the wrong test for you.

Please let us know what the name of the test was. Also if it was the test for the virus the HCV RNA by PCR test you would have also had a viral load. Would you know what the viral load result was?

Hoping it was a lab error
Good luck
Lynn
« Last Edit: June 07, 2016, 02:16:27 pm by Lynn K »
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 audreywald

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  • Posts: 33
Re: relapse after 1 year
« Reply #5 on: June 07, 2016, 03:38:39 pm »
The viral load is now at 744,000 - I started before Harvoni at 16,000,000. Today she had a new blood draw to see if I really am Genotype1a, which I am unless the 3 Dr's before her were wrong. I am going to write down your questions.

But I will tell you this and I am sorry to tell you what we ALL should have been told. When I called "Support Path", after I told the nurse my sad story the first words out of her mouth were , That often happens with Harvoni. So I do urge all of you who were undetectable at 3 or 6 months to get retested at a year or so. My friend's doc in Arizona said he is not sure of the virus being cleared for sure for 2 years. I hope they didn't know that before they put all of us on this wonder drug.

Offline jakas

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  • Posts: 265
Re: relapse after 1 year
« Reply #6 on: June 07, 2016, 04:08:30 pm »
THIS IS so so disturbing !
M/57 yrs.
Contracted (Unknown) 10-20-30 yrs back ??
Treatment Naive
Geno 1a&1b
VL  17+ million
ALT 200+, AST 170+
Fibroscan F4 ( 26+ kpa ) on 8th Dec. 2105
Started Tx 11th Dec.2015 ( 12 wks. Gilead Harvoni)
7/1/2016 :Viral Load|<25 UND.
23/1/2016: ALT 34 , AST 35, ALP 143
8 week NO labs done
EOT:03.03.2016 ( 84 pills eaten )
ALT 26, ALP 124, BIL .54
V/L <25 UND E.O.T.
4 weeks E.O.T. V/L UND::: SVR 4
SVR 12 and  SVR 24 on 16/8/16
Fibro 24.5kpa 23/05/16
SVR 63 05/17
Fibro 17.03.2020 kpa 6.3

Offline KimInTheForest

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  • Believe in yourself
Re: relapse after 1 year
« Reply #7 on: June 07, 2016, 04:19:54 pm »
When I called "Support Path", after I told the nurse my sad story the first words out of her mouth were , That often happens with Harvoni. So I do urge all of you who were undetectable at 3 or 6 months to get retested at a year or so. My friend's doc in Arizona said he is not sure of the virus being cleared for sure for 2 years. I hope they didn't know that before they put all of us on this wonder drug.

Wow! I find this very interesting - and disturbing. It's as though there is no official data collection and tracking of Harvoni patients after SVR12 - at least not by Gilead or any medical organization for that matter. On my clinical trial, Gilead was not interested in any of my test results post SVR12. So they know nothing of my 10 months of unwellness post-tx even though I felt fine going in to treatment.

If post-Harvoni patients are being tracked, it must be very covertly. We only know about your story Audrey because you posted on this forum. I wonder how many others like you are out there, people who achieved SVR24 after Harvoni and then relapsed?

Harvoni is so new, and there is a tremendous amount of potential data collection post-treatment that is being missed and skipped altogether just because there is no centralized mechanism for recording it. The fact that each of our doctors is individually following us for a year or 2 means nothing if Gilead, FDA, AASLD, etc. don't know these outcomes and percentages.

I get my 1-year post-tx test in August.

kim
« Last Edit: June 07, 2016, 04:22:54 pm by KimInTheForest »
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 FutureThinker

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  • Posts: 711
  • Onward and upward!
Re: relapse after 1 year
« Reply #8 on: June 07, 2016, 04:35:16 pm »
Audrey, as a fellow Harvoni patient who just finished treatment 3 weeks ago, I am so very sorry to hear this news. From all I've read this is very unusual, but we certainly are still learning about these new DAAs. Please be sure to have your doctor, or you, tell the FDA & Gilead about this when appropriate. I am hopeful there is an error or maybe a mix up with your report. Glad you had your blood tested again --  please keep us posted!!!  My prayers are for a better outcome.  FT
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline Lynn K

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  • Get tested, get treated, get cured, fight Hep c!
Re: relapse after 1 year
« Reply #9 on: June 07, 2016, 04:35:39 pm »
Ok I don't have the links this second but I know the experts are tracking post treatment results and all I have seen is that the odds of relaps post SVR 12 are very low I can report that I was SVR 44 and I was a difficult case.

So sad to hear about this but the data on the situation here but let's stay calm will dig up reasearch later
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 lporterrn

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  • LucindaPorterRN
    • LucindaPorterRN
Re: relapse after 1 year
« Reply #10 on: June 07, 2016, 04:41:16 pm »
This is shocking news. Let's start with your question,
Quote
Does this mean I am probably going to die of this illness?
No, it does not. First, your liver has had time to dial back some damage, and I would not be surprised if you went from stage 3 to stage 2 or 1 (I went from nearly a 3 to a 0 when I relapsed from PEG+RBV) And as was said, other good treatments are out and ahead.

The question is why. First, there is lab error, so a retest is necessary. It is possible that the 6 month post-test was wrong, and of all the explanations, that is the most likely.
Then the issue is a reinfection. I would ask for a genotype test.
The most unlikely scenario is that you have a condition such as cryoglobulinemia or HIV that would mask the 6 month post-test. Talk to your doc about these. If you don't have either of these, then I would look at the previous possibilities.

This is hugely disappointing, and I appreciate that you brought it to the Forum. Sadly, you won't be the only person to go through this, and the more we share our stories, the more we can help each other through these tough times.
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
https://www.hepmag.com/blogger/lucindakporter

Offline KimInTheForest

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  • Believe in yourself
Re: relapse after 1 year
« Reply #11 on: June 07, 2016, 04:50:58 pm »
Ok I don't have the links this second but I know the experts are tracking post treatment results and all I have seen is that the odds of relaps post SVR 12 are very low I can report that I was SVR 44 and I was a difficult case.

I will be interested to see what you dig up, Lynn. Not that I doubt you. It's just that I am not aware of any mechanism by which any of our individual doctors are submitting our post-treatment data to some centralized medical authority that could then crunch numbers. Plus, some people's doctors follow up with their post-harvoni patients extensively for a long time, others never see their patients again. I have had 2 different liver specialists following me. One says I'm done after my 1-year SVR, the other says the 1-year SVR is irrelevant - if I'm cured at 6 months (which I was) I'm cured forever unless I get re-infected. So there is no consistency in how specialists monitor their patients. And as far as I know, my doctors are not submitting my data to anyone else.

I just don't see what mechanism exists for accurately calculating percentages of relapsers or percentages of people who develop severe chronic illness or cancer immediately after completing Harvoni treatment. All the info is anecdotal, but there is a growing volume on both of those counts.

kim
« Last Edit: June 07, 2016, 04:58:20 pm by KimInTheForest »
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 dragonslayer

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  • Posts: 873
Re: relapse after 1 year
« Reply #12 on: June 07, 2016, 06:27:09 pm »
Here is an interesting article that has been quoted in another thread on this board about delayed relapse:

http://jid.oxfordjournals.org/content/early/2013/11/14/infdis.jit543.full.pdf
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline Lynn K

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  • Get tested, get treated, get cured, fight Hep c!
Re: relapse after 1 year
« Reply #13 on: June 07, 2016, 07:43:30 pm »
OK so far I am looking at

National AIDS Treatment Advocacy Project

http://www.natap.org/

Real World Effectiveness of Ledipasvir/Sofosbuvir in Treatment-Experienced Cirrhotic Genotype 1 Patients with Chronic HCV: A Comparative Analysis of Gilead Sponsored Trials with 4 Real-World Cohorts

I am on the phone with support path getting in contact with a nurse
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 gnatcatcher

  • Member
  • Posts: 1,372
Re: relapse after 1 year
« Reply #14 on: June 07, 2016, 07:56:33 pm »
Dragonslayer, thanks very much for posting that link. So, it seems that HCV can hide successfully elsewhere in the body, and a relapse (as opposed to a new infection) can occur years into the future. It still makes sense to get treated and give the liver respite, even if the rescue turns out not to be permanent.
9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline Lynn K

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Re: relapse after 1 year
« Reply #15 on: June 07, 2016, 08:17:54 pm »
Yes great link
I just got off the phone with the Support Path nurse she said she is only aware of my and one other phone call about a long post treatment relapse and quoted the odds of late relapse as 1% but still not great to be in that category. She suggested searching on clinicaltrials.gov for long term trial results and also that Giliead has information as well.

She also mentioned they have one caller who is participating in a 3 year post treatment study so there are studies being conducted on us long term poet treatment. On issue is there are only a fer of you who have been off treatment for over a year we were the pioneers. The only ones with longer times post were in the clinical trials.

I discussed my history and she asked if it would be ok for Gilead to reach out tome for information as they may be interested in following my case because of my prior treatment history and history of cirrhosis.

But as far as Audrey's situation the nurse added there are new treatment coming so if this didn't work for her there are new treatments coming so hang in there.

But as I said so far what they are seeing is 1% relapse after SVR 12 and the clinical trial data was saying SVR 12 was 99.8% likely cured but unfortunately nothing is 100%

Best to all
Lynn
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 lporterrn

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    • LucindaPorterRN
Re: relapse after 1 year
« Reply #16 on: June 07, 2016, 08:27:54 pm »
This is not a new phenomenon. Late relapses are rare, but they have been around for as long as we've been doing treatment. Researchers have been following post-treatment for many years (I am in a post-treatment study), and when you see a stat quoted such as you have a 100% of a durable SVR following 24 weeks, often what you see is rounding up from what really is 99.8%

However, keep in mind that we don't know if this is a relapse, a reinfection, or a lab mistake.
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
https://www.hepmag.com/blogger/lucindakporter

Offline Lynn K

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Re: relapse after 1 year
« Reply #17 on: June 07, 2016, 08:37:22 pm »
and one more

http://www.hepatitiscentral.com/news/after-being-cured-can-hep-c-return/

Sustained Virologic Response

The benchmark of Hepatitis C treatment, a sustained virologic response (SVR) is as close as we can get to a cure for this disease. SVR is declared if the person’s viral load is non-detectable six months after administration of the last dose of Hepatitis C medication.

Achieving a sustained virologic response usually means the medicine eliminated all traces of Hepatitis C from the body. However, it is possible that a tiny bit of the virus hid and replicated after treatment ends. If this were to happen, it would usually do so within six months – thus the standard of defining SVR at six months. The ability of Hepatitis C viral particles to hide and wait longer than half a year to replicate is slim, but not impossible.

SVR means the virus is probably permanently gone. Hepatitis C is highly unlikely to return after a person achieves SVR, but:

    studies have shown that with a six-month SVR, relapse occurs in 1 to 2 percent of patients.
    the return of Hepatitis C after living one year without the virus is even rarer.

After one year of being free from the virus, the odds of Hepatitis C eradication permanence are much better. In fact, many medical providers stop checking for the presence of Hepatitis C after one year of non-detectable viral particles.

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 Lynn K

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Re: relapse after 1 year
« Reply #18 on: June 07, 2016, 08:38:56 pm »
This is not a new phenomenon. Late relapses are rare, but they have been around for as long as we've been doing treatment. Researchers have been following post-treatment for many years (I am in a post-treatment study), and when you see a stat quoted such as you have a 100% of a durable SVR following 24 weeks, often what you see is rounding up from what really is 99.8%

However, keep in mind that we don't know if this is a relapse, a reinfection, or a lab mistake.

Excellent point still need more testing to be sure what has happened
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 KimInTheForest

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Re: relapse after 1 year
« Reply #19 on: June 08, 2016, 01:20:25 am »
Thanks you Lynn, Lucinda and Paul for the info and article links related to this subject.

kim
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 brie41

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Re: relapse after 1 year
« Reply #20 on: June 08, 2016, 07:58:30 am »
HI Audrey,

  I am so sorry to hear about your relapse.  I truly can't imagine how terrible that must have been for you to find this out.  If Lynn is right and you are in the 1% that is exceptionally cruel.   I wish you all the best and thankfully there are new drugs here and coming that will cure you!!  Brie
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 morab

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  • Lives in the woods
Re: relapse after 1 year
« Reply #21 on: June 08, 2016, 09:16:39 am »
Audrey
I am so sorry to hear this news. Please keep us posted on your updates!
You have so much moral support here on the forum, and hopefully you can be one of the first to get one of the newest drugs in the near future.
Morab
3/2016 G 1a
Alt 84
Ast 62
Fibrosis score lab 0.66
quantitation 894,670
4/23/16 day 6, naive Harvoni 12 week treatment
5/27/16 week 4 lab results UNDETECTED AST 23 ALT17

Offline slats1056

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  • SVR to all and to all a good life!
Re: relapse after 1 year
« Reply #22 on: June 08, 2016, 09:46:53 am »
 Audrey,
  That is bad news , but not a death sentence. Keep Your chin up and keep the faith.
The new Meds are promising. So sorry to hear about Your relapse.

  I have been wondering about the process for following up results post SVR. My Drs. have no idea about any studies and are not providing any info. to anyone post treatment!! While SVR12 is considered undetected, SVR24 is considered cured. Most do not realize that it is not 100%. Joy at defeating the Dragon can cloud the reasoning that it is not a guaranteed cure. Though many are. The medicines are truly amazing, but there is still margin for error.
  Has anyone been contacted about follow up post treatment? Or has it come about by the patient contacting the Pharmaceutical Companies?
  The doubt in the back of ones mind is exacerbated by news like this, however , I am still hopeful that all of us that are in bad shape post treatment are still improving!
 HERE IS TO THE FUTURE! ONWARD AND UPWARD ALL. YOU CAN'T KEEP A GOOD HEPPER DOWN! :)
73 non ab 98 hep c refused pegint/riba
6-15 Gen.1b 1/2 MIL ALT72 AST37 No cirrhosis
7-15  Harvoni 12 weeks
10-14-15 EOT VIRAL LOAD NON-DET  
12-30-15 EOT+12 VIRAL LOAD NON DET  SVR12            8-9-18 HCV LOAD 1.02IU/ml AST22  ALT30 RELAPSE?
9-18-18 confirmed gt 1b relapse
10-16-18 approved 16 weeks Mavyret

Offline AussieRosa

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  • Posts: 226
Re: relapse after 1 year
« Reply #23 on: June 08, 2016, 08:10:10 pm »
Dear, Audrey. I'm so sorry to hear about this terribly disapointing news. After 1 year you must have been so relaxed and comfortable in the knowledge that you were cured, only to have the rug pulled out from under you. A terrible feeling I can only try to imagine. Try to remain hopeful regarding all the new drugs that will be addressing relapse and resistance. Surely there will be a permanent cure for you among them. Wishing you courage and the best of luck!
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 I fightis thetitis

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  • Posts: 129
Re: relapse after 1 year
« Reply #24 on: June 09, 2016, 08:03:28 am »
Hey Audrey,
Hang in there as the new meds in the pipeline from Merk seem very promising.
My Dr. mentioned that even after 24 weeks of Harvoni tx, which I had, does not ensure the meds killed all of the virus completely. especially after 40+ years of living with hep.
Further whatever (and if) virus exist it may be up to our immune system to wipe out any remaining virus.
He suggested I boost my immune system with exercise and diet. even suggested Mediterranean diet.

Along with the Ns5a gene that appears to factor in relapse.
Bottom line is still a lot of guess work.

Best to you!!

M59  56@start of TX. date infected:1976
diagnosed 1997 - asymtomatic
Genotype 1a
AST 111 -ALT 124 - AFP -89
Viral Load 1900000 - Log 6.28
Fibro Test F4 ActiTest A3
Harvoni 24 wks - start date 11/24/15

6 Week Labs VL Undetected!
104 weeks EOT Undetected.

8/25/17 Fibrosure score 80 = F4
11/10/17 Fibroscan 7.5 mean 1.6 m/s = F2
8/2018 Ultra sound normal.

Offline FutureThinker

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Re: relapse after 1 year
« Reply #25 on: June 09, 2016, 12:33:46 pm »
I did a brief scan of the literature on delayed relapse and there just isn't much on this yet, as Harvoni has not even been on the market 2 years yet. There just hasn't been enough time for data to be collected w/ DAA treatment on this. Being the pioneers (I prefer that term vs. guinea pigs) in this phase of HCV treatment development, this is the kind of info that will be coming out over the next several years. We're just going to have to wait and see (and pray). All of us need to take the lead in making sure either our doctors, or us, inform the FDA on these events. Anyone have the contact info?

The article cited by dragonslayer in this thread is from 2013 and while interesting, an awful lot has transpired with available drugs since that time. The 2 articles I did read (found one from this year in Clinical Infectious Diseases, 1-19-16) show a very, very low risk of delayed relapse, 1% or less, so that is good news! It appears this virus might be harbored elsewhere in our bodies other than the liver, so that will be a big part of research, I am sure.

Audrey, I hope you'll be getting RAV testing, as this is an important piece of the puzzle. This kind of news scares all of us to death...... but the reality is none of the treatments thus far are 100% effective....... yet.  I am confident we are headed in that direction.

Please keep us posted, Audrey, and you are in all of our thoughts! Thank you again for posting, FT
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline FutureThinker

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Re: relapse after 1 year
« Reply #26 on: June 09, 2016, 12:40:34 pm »
Another thought:  Some of us are getting VL tests at various time lines after SVR, others are not.  Until this issue of delayed relapse is figured out, maybe we all should be getting VL tests every 6-12 months?? For how many years, the cancer standard of 5 years? Seems at least annually may be warranted, until this issue is understood.

I appreciate your thoughts and thanks, FT
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline fourlocos

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  • Posts: 7
Re: relapse after 1 year
« Reply #27 on: June 09, 2016, 12:57:26 pm »
Audrey I am really sorry to hear you relapsed.  I hope that the newer drugs do it for you.  I am 16 months post treatment and will be tested again in November.  Curious to see what that shows.  I am glad the moderators contacted Gilead and have provided you and all of us with more information. 

Offline Lynn K

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Re: relapse after 1 year
« Reply #28 on: June 09, 2016, 11:24:33 pm »
Anyone have the contact info?

Got this from the Harvoni prescribing information sheet:

To report SUSPECTED ADVERSE REACTIONS, contact Gilead Sciences, Inc. at 1-800-GILEAD-5 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
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 FutureThinker

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  • Onward and upward!
Re: relapse after 1 year
« Reply #29 on: June 10, 2016, 12:22:42 am »
Thanks very much, Lynn.  I'm going to print that off for my files! FT
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline audreywald

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  • Posts: 33
Re: relapse after 1 year
« Reply #30 on: June 10, 2016, 01:26:07 pm »
For those of you who asked, my test was the hcv/Rna, pcr. I went in six months from 0 to 744, 000. Which I guess was quite alarming - that it shot up so fast. They have given me another geno test which I THINK is even more precise. I will have more answers in a week or two.
I am scared to death. I have another illness called gastroparesis which means that the food passes through my stomach at a very slow pace, which means I am always nauseous. They are trying to match me up once they get whatever info they want with the right drug. IF Medicare will pay. But what is the point of being treated for the gastro disease if I'm going to be nauseous all the time anyway from the new med I get or from the Hep C itself. I have had it 40 years
Wouldn't that just suck, to go thru the peg intron (12 years ago, and they  took me off after 13 weeks) then wait all these years for a better chance, do 6 months of Harvoni, and then the companies that pay give up on me. I am getting old but I think I need to be here for awhile if possible. I have a 12 year old grandson with severe autism. I take him and his 5 year old pistol of a brother every week. I also have a 23 year old grandson who has been missing 2 and a half years whom I raised who has a lot of mental health issues. A lot of people think he is still alive. What if he one day comes home and I am deceased because I did not fight with everything I've got> I am also married to a good man, going on 21 years of marriage.

I have to try to be strong and face this dragon. We all do. Please feel free to  reply to me. I live in a small town  in Arkansas , the heart of the Bible belt and it's very lonely here for me.

Offline Lynn K

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Re: relapse after 1 year
« Reply #31 on: June 10, 2016, 01:35:41 pm »
Hi so sad for your relapse just wanted  to let you know that a large increase in virus in a short period of time is not uncommon  that is the nature of any virus that is their goal to reproduce as rapidly as possible.  When I relapsed on Sovaldi Olysio  my prior treatment viral load was 2 million  I was not detected at EOT  but 12 weeks later when I retested my viral load was at 2.4 million. They're working on finding new medicines all the time I am sure they will find something that works for you soon
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 audreywald

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  • Posts: 33
Re: relapse after 1 year
« Reply #32 on: June 10, 2016, 01:39:36 pm »
There is NO chance of my being reinfected by risky behavior. None. And after 40 years, I am pretty savvy as to what might cause it.

Offline Lynn K

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  • Get tested, get treated, get cured, fight Hep c!
Re: relapse after 1 year
« Reply #33 on: June 10, 2016, 01:52:28 pm »
I don't think anyone thinks that I hope I didn't say something to make you think I felt that way. I hope your doctors can figure out the cause for your relapse. Are they testing you for resistance factors?
« Last Edit: June 10, 2016, 01:54:47 pm by Lynn K »
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 audreywald

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  • Posts: 33
Re: relapse after 1 year
« Reply #34 on: June 10, 2016, 02:36:57 pm »
I don't think anyone thinks that I hope I didn't say something to make you think I felt that way. I hope your doctors can figure out the cause for your relapse. Are they testing you for resistance factors?


Oh no, Lynne, my nurses had to ask that same question. 40 years ago, yes, that behavior is what got me here. But that was in a galaxy far, far away, in another life. The life of the young and foolish, of which I was both.

It is very important that those of you who were on Harvoni contact Support Path. Gilead wants to know everything that is happening to us.

Offline morab

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  • Lives in the woods
Re: relapse after 1 year
« Reply #35 on: June 10, 2016, 02:49:39 pm »
audrey
Thanks for keeping us all informed of the many possibilities! I think it is going to take those of us taking these drugs to do the reporting, as from what I have experienced, the specialists are not!
Do you go to Little Rock to see a specialist? I am in NW Arkansas! I hope you don't have to drive that far!
I told my GP who is following me about your case, he agreed that he would watch me much closer after hearing this news and do followup every year for many years to come checking for any relapse.
I hope Gilead will help you out with the newest best drugs hitting the market soon!
Please keep us posted!
Morab
3/2016 G 1a
Alt 84
Ast 62
Fibrosis score lab 0.66
quantitation 894,670
4/23/16 day 6, naive Harvoni 12 week treatment
5/27/16 week 4 lab results UNDETECTED AST 23 ALT17

Offline audreywald

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Re: relapse after 1 year
« Reply #36 on: June 10, 2016, 04:50:36 pm »
I go to Jonesboro for my specialist. That is my Nurse specialist. Don't get to see the Dr. anymore. I live in Northeast Arkansas, at least I think it is. I live in Wynne. I have been here 7 years but I am from Chicago. Have not gotten comfortable here. But my daughter and grandkids live here so here I will stay. But this is not my home. I am a stranger in a strange land and have not been able to connect with anyone.  I guess you can tell I am not happy here.

Offline morab

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  • Lives in the woods
Re: relapse after 1 year
« Reply #37 on: June 10, 2016, 05:06:52 pm »
Oh audrey
The South can be really hard to get used to if you are not born here. I have relatives in Chicago and spent many childhood vacations in Chicago, then I did a few Art show's there and had a blast staying with my cousin and riding the L train.
Hang in there and I hope you can make a new friend in your area! Keep us posted on what you find out about your relapse!
Cheering for you!
Morab
3/2016 G 1a
Alt 84
Ast 62
Fibrosis score lab 0.66
quantitation 894,670
4/23/16 day 6, naive Harvoni 12 week treatment
5/27/16 week 4 lab results UNDETECTED AST 23 ALT17

Offline brie41

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  • Posts: 191
Re: relapse after 1 year
« Reply #38 on: June 10, 2016, 06:21:13 pm »
Hi Audrey,

   At least you have friends here, always!!  You have a full plate for sure, and I truly hope you find out what happened to your grandson.  How awful and I am sure not knowing is the hardest part.  They say God does not give us more than we can  handle, but that is questionable sometimes.  Please keep the faith that the next treatment will cure you for good.  Take care.  Brie
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 gnatcatcher

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Re: relapse after 1 year
« Reply #39 on: June 10, 2016, 07:13:15 pm »
Audrey, does your Nurse specialist understand the importance of your having resistance testing so that your next treatment won't contain a medicine that your body would resist? Does he or she consult with a hepatologist, perhaps by phone or email? As with doctors, NPs can vary widely in knowledge and experience -- I hope you've got a good one who keeps abreast of the latest advances and treatment recommendations.

You've got plenty of reasons to cultivate your will to live, even if you're being asked to bloom where you weren't planted. Wishing you WELL,

Gnatty
9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline dragonslayer

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Re: relapse after 1 year
« Reply #40 on: June 10, 2016, 07:46:39 pm »
Folks,

Curious about the role of resistance. If one is resistant to a medication, how is it possible that one can be undetected for nearly a year as a result of taking this medication, before it becomes detected again?   Wouldnt that point to something else at work other than drug resistance?   
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline gnatcatcher

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  • Posts: 1,372
Re: relapse after 1 year
« Reply #41 on: June 10, 2016, 09:03:29 pm »
Good point, but I was looking ahead to her future treatment. Now that resistance testing is becoming more widely used, surely someone who is having to go through yet another treatment would be best served by having anything ineffective ruled out.
9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline drummerman

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  • Posts: 538
  • For those regarded as warriors....
Re: relapse after 1 year
« Reply #42 on: June 12, 2016, 12:05:08 am »
audrey
Thanks for keeping us all informed of the many possibilities! I think it is going to take those of us taking these drugs to do the reporting, as from what I have experienced, the specialists are not!
Do you go to Little Rock to see a specialist? I am in NW Arkansas! I hope you don't have to drive that far!
I told my GP who is following me about your case, he agreed that he would watch me much closer after hearing this news and do followup every year for many years to come checking for any relapse.
I hope Gilead will help you out with the newest best drugs hitting the market soon!
Please keep us posted!
Morab

Just curious... what specialist in LR are you referring to??  I never could find one.  All of the hepatologists at the med center are too busy doing transplants and I never got to see one face to face... although some times I did see their initials on some of my charts.   

Eventually just wound up with a gastroenterologist and went with viekira.

Would be interested to know if you found a  hepatologist that will treat hcv patients in LR.

dm
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline morab

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Re: relapse after 1 year
« Reply #43 on: June 12, 2016, 08:01:16 am »
I am in NW AR and just assumed there would be a Hep C specialist in Little Rock. You would think there would be someone there, with the University Hopsitals  there. I have a sister with NASH who see's someone in Little Rock, not sure who she see's though.
I am will ask her who she see's may just be seeing a GI person and go there for her testing.
Will get back with you on that one.
My sister who is going there for testing is loosing her mind, her liver is bad and vitamin level's so low so not sure how much true information I will get out of her.
It sounds like most of us in the US see a GI person, mine in NW AR did not schedule any followup nor future appointments and left me hanging. I am lucky to have a really fantastic General Practitioner.
Morab
3/2016 G 1a
Alt 84
Ast 62
Fibrosis score lab 0.66
quantitation 894,670
4/23/16 day 6, naive Harvoni 12 week treatment
5/27/16 week 4 lab results UNDETECTED AST 23 ALT17

Offline drummerman

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  • For those regarded as warriors....
Re: relapse after 1 year
« Reply #44 on: June 12, 2016, 10:24:58 am »
I am in NW AR and just assumed there would be a Hep C specialist in Little Rock. You would think there would be someone there, with the University Hopsitals  there. I have a sister with NASH who see's someone in Little Rock, not sure who she see's though.
I am will ask her who she see's may just be seeing a GI person and go there for her testing.
Will get back with you on that one.
My sister who is going there for testing is loosing her mind, her liver is bad and vitamin level's so low so not sure how much true information I will get out of her.
It sounds like most of us in the US see a GI person, mine in NW AR did not schedule any followup nor future appointments and left me hanging. I am lucky to have a really fantastic General Practitioner.
Morab

Well, like I said, when I was being treated at UAMS , I never saw a specialist, but did see his initials on papers at times.  Never met him.  Only saw a nurse.

Round 2 - I had a gastro.   Guess its all you can get in this area.

dm
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline morab

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Re: relapse after 1 year
« Reply #45 on: June 12, 2016, 10:40:37 am »
Drummerman
Are you going to be retested after your 1 year mark EOT? I sure will after reading of relapses.
Morab
3/2016 G 1a
Alt 84
Ast 62
Fibrosis score lab 0.66
quantitation 894,670
4/23/16 day 6, naive Harvoni 12 week treatment
5/27/16 week 4 lab results UNDETECTED AST 23 ALT17

Offline dragonslayer

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Re: relapse after 1 year
« Reply #46 on: June 12, 2016, 02:50:37 pm »
I'm about 1.5 yrs post treatment.  I was undetected at 48 wks post, but Id be lying if I said the results posted by the op didnt shake me up... Given the incredibly small odds related to delayed relapse, my plan is to continue to get my AST/ALT done for my annual physical in january, and dont see a need to get a yearly viral load done unless either of these liver function tests show a spike.  Those tests were the ones to tip I had the disease initially, and so long as they stay normal, Im not going to obsess about it.
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline FutureThinker

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  • Onward and upward!
Re: relapse after 1 year
« Reply #47 on: June 12, 2016, 03:11:54 pm »
Hi all, this topic of delayed relapse is definitely one for all of us to discuss with our medical personnel. It just may make all of us make it a priority to get an annual physical and blood work, in which ALT/AST will be a part.  Dragonslayer is right in that those are the numbers that send up the red flag.

When I was diagnosed in '11 I had been a bit lax in getting myself in for my annual physical ---- actually, it was a toenail fungal infection that was the primary reason I went in, and the blood work for the meds to treat that showed the elevated liver enzymes. The rest is history. The annual blood work doesn't seem to be an option anymore, at this point.  FT
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline beto

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  • "no risk it, no biscuit"
Re: relapse after 1 year
« Reply #48 on: June 12, 2016, 06:10:45 pm »
Just a word of caution.

ALT/AST is no doubt the best cheap and easy test for red flagging HCV.  However, there are other things that can raise these numbers...so, if they come up higher on a test best not to assume too much.  We all know what it is like to fear the worst.  We all kinda wrote that book.  I agree, it is damn time we see more attention from the medical and health community tackling the crap we all do not want to deal with.  Relapse, scary side effects and post SVR difficulties even if rare.  These subject don't sell pills, however, they especially can not be ignored now.  right now!!! not five years from now.  If I knew everything I know now a year ago, I would persue these meds with the same power of conviction as I did when Harvoni was an omnipotent deity.  But we the pioneers of these amazing but not completely understood drugs, owe it to those in the wings with stars in there eyes to get this discussion beyond our tight forum community.

Audry-  My heat goes out to you as well.  Hang around and let us know how you are doing.  Everyone on this forum is pulling for you.  Let's get you undetected again for keeps.  Peace...
HCV/nonA,nonB acute phase 1975
HCV detected active 1990
HCV persistent chronic diagnosis 1995
1995 liver enzymes mild elevations
1996 Biopsy F2 fibrosis
treatment naive geno 1-A
2000-to early 2015 Viral load 150, 000 to 800, 000
recent liver enzymes before treatment alt/ast 59to209,  Fibroscan F4,cirrhosis
start tx Harvoni 7/11/2015
6.5 week-UD-ast/alt 25/25
9wk-UD-ast18 alt23
10/3/15 completed tx
11/5/15 new fibroscan f0-f1 amazed
6wk EOT UD ast/alt 20/20
12EOT-UD-ast/alt19/21
25wk-SVR! 19/18

Offline I fightis thetitis

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  • Posts: 129
Re: relapse after 1 year
« Reply #49 on: June 12, 2016, 07:37:17 pm »
Audrey,

My GI is in Orange California and I asked the head nurse on Friday if they have seen relapse a year post TX.
Of the 1,200 Harvoni patients the 3 GI's have had from their office since 10-2014, approx 300 are 52 weeks post TX. There was one relapser who was on 24 week Harvoni only tx and that patient confirmed she had not been compliant through the 24 week treatment.

That patient had cut the Harvoni into two doses and took them 1-hour apart from each dose. also was not consistent with time of days.
The patient was UD @ 36 weeks post and positive at 52 weeks post.

Nurse had no explanations or theories if this was a factor with their relapse.
So.... to see if there is any connection here and purely from a Sherlock Holmes type curiosity, were you always consistent when you took your Harvoni?

I wonder if any other relapsers can chime in to see if a possible time of day, consistency ect issue, just to rule that notion out.

Of course the conventional is to assume there is no correlation between relapse and time of day or compliance post 52 week EOT. But doesn't hurt.

I hope you are feeling better and best of luck to you!!  Friends, sympathizers and love here!

Best always,
Greg
M59  56@start of TX. date infected:1976
diagnosed 1997 - asymtomatic
Genotype 1a
AST 111 -ALT 124 - AFP -89
Viral Load 1900000 - Log 6.28
Fibro Test F4 ActiTest A3
Harvoni 24 wks - start date 11/24/15

6 Week Labs VL Undetected!
104 weeks EOT Undetected.

8/25/17 Fibrosure score 80 = F4
11/10/17 Fibroscan 7.5 mean 1.6 m/s = F2
8/2018 Ultra sound normal.

Offline drummerman

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  • For those regarded as warriors....
Re: relapse after 1 year
« Reply #50 on: June 12, 2016, 09:00:58 pm »
Drummerman
Are you going to be retested after your 1 year mark EOT? I sure will after reading of relapses.
Morab

At this point I was planning on waiting 5 years.  But , if we see more and more relapses then I will reconsider.

dm
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline Baxter

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  • Posts: 87
Re: relapse after 1 year
« Reply #51 on: June 13, 2016, 04:40:00 pm »
Audrey,

My GI is in Orange California and I asked the head nurse on Friday if they have seen relapse a year post TX.
Of the 1,200 Harvoni patients the 3 GI's have had from their office since 10-2014, approx 300 are 52 weeks post TX. There was one relapser who was on 24 week Harvoni only tx and that patient confirmed she had not been compliant through the 24 week treatment.

That patient had cut the Harvoni into two doses and took them 1-hour apart from each dose. also was not consistent with time of days.
The patient was UD @ 36 weeks post and positive at 52 weeks post.

Nurse had no explanations or theories if this was a factor with their relapse.
So.... to see if there is any connection here and purely from a Sherlock Holmes type curiosity, were you always consistent when you took your Harvoni?

I wonder if any other relapsers can chime in to see if a possible time of day, consistency ect issue, just to rule that notion out.

Of course the conventional is to assume there is no correlation between relapse and time of day or compliance post 52 week EOT. But doesn't hurt.

I wonder what in the world inspired her to do that? Maybe she was one of those who had unpleasant sides, and thought this might minimize them.

I suppose she assumed it didn't make any difference - and in all honesty, it probably didn't - but still! If the prescribing sheet told me take each pill while sitting cross-legged and wearing a flowerpot on my head, I'd probably take all 84 pills while sitting cross-legged and wearing a flowerpot on my head. No matter how silly it seemed. Why not?

Of the 1200 other patients (well, 1199 other patients) who've cycled through that clinic in the last 18 months, you have to assume that at least some of them probably also strayed outside the bounds of compliance, and some of them perhaps much more than she. Stands to reason that there had to be someone in a group that size who missed a dose or two, or drank alcohol, or took drugs, or whatever. So while her odd habit could theoretically have been a factor, it would be hard to point your finger at that and say, "ah-ha! that's it!"

My guess is it was just luck of the draw Most people win, but a tiny percentage get that really short straw. It was just her lot to get the short one, unfortunately.
« Last Edit: June 13, 2016, 06:08:09 pm by Baxter »
Gen 1a
Inf. '85
Dx '98
'98 biopsy - Grade 2, Stage 2, VL 7 mil
'01 biopsy - Grade 1, Stage 1, VL 1.5 mil
'08 biopsy - Grade 1, Stage 1, VL 3.5 mil
'12 biopsy - Grade 1, Stage 1, VL 3.5 mil
'16 Fibrosure - Grade I, Stage 3, VL 6.4 mil and 4.8 mil
4/23/16 - ALT 89, AST 50, pltlts 120k. Started 12 wks Harvoni
4/31/16 - ALT 30, AST 21, pltlts 125k
4/14/16 - ALT 25, AST 16, pltlts 126k, VL 69
5/11/16 - ALT 28, AST 21, pltlts 140k,VL <15
6/7/16 -EOT, UNDETECTED!
9/7/16 - cured. Low Stage 2 fibrosis

Offline Baxter

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Re: relapse after 1 year
« Reply #52 on: June 13, 2016, 04:41:56 pm »
Just a word of caution.

ALT/AST is no doubt the best cheap and easy test for red flagging HCV.  However, there are other things that can raise these numbers...so, if they come up higher on a test best not to assume too much. 

No, but at least it's an indicator. A canary in a coal mine. Just something to let you know you need to dig a little deeper.
Gen 1a
Inf. '85
Dx '98
'98 biopsy - Grade 2, Stage 2, VL 7 mil
'01 biopsy - Grade 1, Stage 1, VL 1.5 mil
'08 biopsy - Grade 1, Stage 1, VL 3.5 mil
'12 biopsy - Grade 1, Stage 1, VL 3.5 mil
'16 Fibrosure - Grade I, Stage 3, VL 6.4 mil and 4.8 mil
4/23/16 - ALT 89, AST 50, pltlts 120k. Started 12 wks Harvoni
4/31/16 - ALT 30, AST 21, pltlts 125k
4/14/16 - ALT 25, AST 16, pltlts 126k, VL 69
5/11/16 - ALT 28, AST 21, pltlts 140k,VL <15
6/7/16 -EOT, UNDETECTED!
9/7/16 - cured. Low Stage 2 fibrosis

Offline I fightis thetitis

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  • Posts: 129
Re: relapse after 1 year
« Reply #53 on: June 13, 2016, 07:57:23 pm »
Baxter,

Well said and I agree with your take.
With the avail info we can only draw assumptions as to why she chose to be non-compliant with TX.

As to what is the actual cause of relapse, I suspect many of us look forward to the day that question is answered.

Blessings,

G
M59  56@start of TX. date infected:1976
diagnosed 1997 - asymtomatic
Genotype 1a
AST 111 -ALT 124 - AFP -89
Viral Load 1900000 - Log 6.28
Fibro Test F4 ActiTest A3
Harvoni 24 wks - start date 11/24/15

6 Week Labs VL Undetected!
104 weeks EOT Undetected.

8/25/17 Fibrosure score 80 = F4
11/10/17 Fibroscan 7.5 mean 1.6 m/s = F2
8/2018 Ultra sound normal.

Offline Lynn K

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  • Get tested, get treated, get cured, fight Hep c!
Re: relapse after 1 year
« Reply #54 on: June 13, 2016, 09:34:12 pm »
Yeah
I was debating if I wanted to get tested at 24 months I guess I am more leaning on asking for a 2 year test now in light of this situation
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 jakas

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  • Posts: 265
Re: relapse after 1 year
« Reply #55 on: June 14, 2016, 01:37:04 pm »
This is the first case I have heard of
M/57 yrs.
Contracted (Unknown) 10-20-30 yrs back ??
Treatment Naive
Geno 1a&1b
VL  17+ million
ALT 200+, AST 170+
Fibroscan F4 ( 26+ kpa ) on 8th Dec. 2105
Started Tx 11th Dec.2015 ( 12 wks. Gilead Harvoni)
7/1/2016 :Viral Load|<25 UND.
23/1/2016: ALT 34 , AST 35, ALP 143
8 week NO labs done
EOT:03.03.2016 ( 84 pills eaten )
ALT 26, ALP 124, BIL .54
V/L <25 UND E.O.T.
4 weeks E.O.T. V/L UND::: SVR 4
SVR 12 and  SVR 24 on 16/8/16
Fibro 24.5kpa 23/05/16
SVR 63 05/17
Fibro 17.03.2020 kpa 6.3

Offline MelHu

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  • Posts: 33
Re: relapse after 1 year
« Reply #56 on: June 21, 2016, 01:13:30 pm »
Hey Audrey
Sorry to hear of the relapse as I'm sure it's disappointing and discouraging, but I too worry about that.  I read somewhere that someone with early stage multiple myeloma (bone marrow cancer)  relapsed. I've been monitored for that since 2003. So that thought is constantly on my mind. But I have to say that if SVR lasts 6 months or 5 years, at least our liver gets a break. In the meantime we can all look forward to the future of these treatments.
Paul thanks for that article and as always your input and the input of Ms Porter, Lynn, Kim and all the regulars I feel grateful for the comments and advice.  Money can't buy that! 
Genotype 2b
Probably contacted in 1979
3/2015 VL 3,250,000
   Alt 70.    Ast 31 U/L
   F3 liver status
Sovaldi/ribavirin
12week duration 6/28/15-9/19/15
TX naive
7/25/15 VL 49 IU/ml
   Alt 11
8/22/15 VL 40 IU/ml detected. Alt 9
9/19/15 VL <20 IU/ml detected Alt 12
10/21/15 VL <20 IU/ml detected not-quantifiable
11/24/15  8 week EOT UNDETECTED
3/19/16  6 month EOT Undetected  SVR
I am truly blessed!!!
Finally!  I am truly thankful to be free of it!

Offline GLCII

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Re: relapse after 1 year
« Reply #57 on: June 26, 2016, 08:13:25 pm »
I wasn't expecting to ever read something like this. Needless to say, it's blowing my mind. Talk about our worst fears coming true.  :o

Is it possible that this is a case of reinfection?

With the fast replication of the Hep C virus, I would think it would have popped its ugly head up the first chance it got after the Harvoni left the system. After the three interferon treatments I did, the virus always popped up within the first two weeks.

Gileads commercials are claiming cured after 90 days of SVR. For the virus to show up over a year after treatment ended just doesn't seem right. I hope it's not right.

Again, could this be a case of reinfection? Maybe a pair of missed clippers and old tooth brush, etc? Even that would be slim considering the virus would die after so long of just sitting there.

I don't want to be insensitive but I hope there is more to this story than it just came back.
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 beto

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  • "no risk it, no biscuit"
Re: relapse after 1 year
« Reply #58 on: June 27, 2016, 01:31:47 pm »
GLC, All,

Disconcerting information true, however, there always was a likelyhood of this type of thing happening.  I have a friend that was diagnosed with geno 3 around the same time my 1A turned up 20 years ago when they renamed nonAnonB.  She did just 6 months of interferon/riba.  Had sides that were not that bad and was cured...zero liver damage.  I just ran into her and she is still hep-c free after more than 15 years (her vl was 13 million before treatment).  I post this because it shows that cures happened even with the old inferior drugs and stay.  she was not alone.  For the few unfortunates that relapse or reinfect...they are going to be cured.  For a great majority of us that reached SVR on harvoni or other DAA's we will stay in the clear...I feel pretty certain of that.  We however are the frontlines and we will have to have patience I guess.

There is a lot of attention on these drugs and hep c now whereas, there was not before.  All this attention will keep the dragon slaying machine fine tuning cures for those with stubborn infections.  Let's all stay strong and keep up the fine support for everyone on this mission.  We all got this.  All of us.
HCV/nonA,nonB acute phase 1975
HCV detected active 1990
HCV persistent chronic diagnosis 1995
1995 liver enzymes mild elevations
1996 Biopsy F2 fibrosis
treatment naive geno 1-A
2000-to early 2015 Viral load 150, 000 to 800, 000
recent liver enzymes before treatment alt/ast 59to209,  Fibroscan F4,cirrhosis
start tx Harvoni 7/11/2015
6.5 week-UD-ast/alt 25/25
9wk-UD-ast18 alt23
10/3/15 completed tx
11/5/15 new fibroscan f0-f1 amazed
6wk EOT UD ast/alt 20/20
12EOT-UD-ast/alt19/21
25wk-SVR! 19/18

Offline AussieRosa

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Re: relapse after 1 year
« Reply #59 on: June 27, 2016, 09:17:31 pm »
Thanks for those words of reason and calm reassurance, Beto. I, too, am certain that our cures are real for at least 99% of us. We know from one of the links to a study posted above that for a rare tiny percent it has always been true that there were cases of delayed/late relapse. It stands to reason that the mechanism of action in those late relapses (such as extra-hepatic reservoirs of the virus, mutations to non-replicative strains that mutate back into replicative ability) will remain even with these new drugs. With odds of less than 1% that we'll be a late relapser, I think we can rest easy. Although, I know it's human nature to fear the unkown.
« Last Edit: June 27, 2016, 09:24:39 pm by AussieRosa »
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 jakas

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  • Posts: 265
Re: relapse after 1 year
« Reply #60 on: June 29, 2016, 02:26:06 pm »
COPY AND PASTE;  ;)

SVR means Sustained Viral Response.

When we stop the medications if there is no virus left you will remain undetected and this is SVR.

Undetected at 4 weeks post finishing - SVR4 - predicts a 96% chance of permanent cure

Undetected at 12 weeks post finishing - SVR12 - predicts a 99% chance of permanent cure

Undetected at 24 weeks post finishing - SVR24 - predicts a 99.9% chance of permanent cure

So if you finish treatment and there is virus left it will grow back, your viral load will increase again and you relapse.

If we can not detect any virus you are at SVR and the longer that remains the case the more certain we are it is permanent.

Patients reaching SVR24 post interferon/ribavirin have remained virus free for 18 years of follow up.

With DAAs we don't have that length of follow up but basically with no drugs to hold the virus off if it is still present it grows back, and if it is not still present it can not grow back because it is gone.

You can be confident at SVR4, really confident at SVR12 and pronounce yourself cured at SVR24. There is a strong suspicion that anyone relapsing after SVR24 is not a relapse, but rather a reinfection because if the virus has had 24 drug weeks to grow back and has not.....
M/57 yrs.
Contracted (Unknown) 10-20-30 yrs back ??
Treatment Naive
Geno 1a&1b
VL  17+ million
ALT 200+, AST 170+
Fibroscan F4 ( 26+ kpa ) on 8th Dec. 2105
Started Tx 11th Dec.2015 ( 12 wks. Gilead Harvoni)
7/1/2016 :Viral Load|<25 UND.
23/1/2016: ALT 34 , AST 35, ALP 143
8 week NO labs done
EOT:03.03.2016 ( 84 pills eaten )
ALT 26, ALP 124, BIL .54
V/L <25 UND E.O.T.
4 weeks E.O.T. V/L UND::: SVR 4
SVR 12 and  SVR 24 on 16/8/16
Fibro 24.5kpa 23/05/16
SVR 63 05/17
Fibro 17.03.2020 kpa 6.3

Offline audreywald

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  • Posts: 33
Re: relapse after 1 year
« Reply #61 on: June 29, 2016, 03:32:00 pm »
I have been looking and looking for this site. I am so glad I finally found you all.

Guess what? On May 26th is when I had my viral load taken and it came back as 744,000. Everyone (including all the professionals working with me) said they did not think this had ever happened. So I had my genotype rechecked and they rechecked my viral load at the same time, which I did not know about until they called me recently. Well, guess what? It came back as 0 - so a lab mistake was made. I am going next week to the best lab, I think one that does its own testing then and there. My doc says this result will be definitive.

So for those of you who got worried that this could possibly happen to them, there MAY be no reason to worry.

I will let you know as soon as I do. Thanks so much for all the feedback.  :-*

Offline KimInTheForest

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  • Believe in yourself
Re: relapse after 1 year
« Reply #62 on: June 29, 2016, 03:37:14 pm »
I have been looking and looking for this site. I am so glad I finally found you all.

Guess what? On May 26th is when I had my viral load taken and it came back as 744,000. Everyone (including all the professionals working with me) said they did not think this had ever happened. So I had my genotype rechecked and they rechecked my viral load at the same time, which I did not know about until they called me recently. Well, guess what? It came back as 0 - so a lab mistake was made. I am going next week to the best lab, I think one that does its own testing then and there. My doc says this result will be definitive.

So for those of you who got worried that this could possibly happen to them, there MAY be no reason to worry.

I will let you know as soon as I do. Thanks so much for all the feedback.  :-*

WOW! That would be fantastic if it is all just a lab mistake, Audrey. And it would certainly make the most sense. But what a mistake! That lab really needs to up its game.

Good luck on your next test at different lab, Audrey. I have a good feeling about this! :)

kim
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 gnatcatcher

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Re: relapse after 1 year
« Reply #63 on: June 29, 2016, 03:47:17 pm »
Audrey, I'm elated at your latest result. Fingers crossed that the definitive test confirms this one and the SVR12 and SVR24.

Gnatty
9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline Lynn K

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  • Get tested, get treated, get cured, fight Hep c!
Re: relapse after 1 year
« Reply #64 on: June 29, 2016, 04:16:29 pm »
Dancing in the street! That is what we have all been hoping for that it was a HUGE mistake!

SVR SVR SVR fingers, toes , eyes crossed!
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 FutureThinker

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  • Onward and upward!
Re: relapse after 1 year
« Reply #65 on: June 29, 2016, 07:38:12 pm »
Audrey, you got the conga line going again!!!  I am so relieved this appears to to be a lab error.  Thrilled to hear you are likely UD!!  Keep us posted and fingers still crossed, FT
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline AussieRosa

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Re: relapse after 1 year
« Reply #66 on: June 29, 2016, 10:00:17 pm »
This is fantastic news. You must be so relieved, AudreyWald
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 Mila

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  • Posts: 35
Re: relapse after 1 year
« Reply #67 on: June 29, 2016, 10:15:09 pm »
Wow! I find this very interesting - and disturbing. It's as though there is no official data collection and tracking of Harvoni patients after SVR12 - at least not by Gilead or any medical organization for that matter. On my clinical trial, Gilead was not interested in any of my test results post SVR12. So they know nothing of my 10 months of unwellness post-tx even though I felt fine going in to treatment.

If post-Harvoni patients are being tracked, it must be very covertly. We only know about your story Audrey because you posted on this forum. I wonder how many others like you are out there, people who achieved SVR24 after Harvoni and then relapsed?

Harvoni is so new, and there is a tremendous amount of potential data collection post-treatment that is being missed and skipped altogether just because there is no centralized mechanism for recording it. The fact that each of our doctors is individually following us for a year or 2 means nothing if Gilead, FDA, AASLD, etc. don't know these outcomes and percentages.

I get my 1-year post-tx test in August.

kim

Hello This is my first time posting here & don't think I quite have it down..I was officially diagnosed last year...in response to Harvoni support path, I was on the phone with a harvoni nurse last week discussing side effects and she told me flat out that the nurse line was there to help us but also data collection because they "really don't know very much about it" and are depending on us the user to inform them what we're going through. My impression was they know only slightly more than we do about side effects.
« Last Edit: June 29, 2016, 10:25:28 pm by Mila »
Infected probably 1977/78
1st diagnosed: 2009
UN-diagnosed: 2012
RE-diagnosed by new Dr 2015
naive treament
genome type: 1a
Viral count at start of Harvoni treatment: 8,090,000
AST/SG: 51
ALT: 71
F1-2

4 Week:
HCV RNA: NOT DETECTED
AST/SG: 31
ALT: 44

8 Week:
HCV RNA: NOT DETECTED
AST: 33
ALT: 45

Week 12:
No HepC detected repeat in 3 months

2 years:
non detected

Offline morab

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  • Lives in the woods
Re: relapse after 1 year
« Reply #68 on: June 29, 2016, 10:16:14 pm »
Audrey. Thank god for happy mistakes!
Morab
3/2016 G 1a
Alt 84
Ast 62
Fibrosis score lab 0.66
quantitation 894,670
4/23/16 day 6, naive Harvoni 12 week treatment
5/27/16 week 4 lab results UNDETECTED AST 23 ALT17

Offline FutureThinker

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  • Posts: 711
  • Onward and upward!
Re: relapse after 1 year
« Reply #69 on: June 30, 2016, 01:07:51 am »
Mila, you are right in that we are the pioneers in this new DAA era. It is a hard decision. These DAAs are so much more effective and tolerable than any of the previous treatments available. Some of us have had this disease for 3-4 decades and it's eating away at our livers, quality of life and future. This was the most pressing aspect for me starting treatment, the lack of long term data on these drugs. But it was try it now or wait while the detrimental effects continued. It wasn't an easy decision.

We all just need to be diligent in getting relevant info to the people that need to know our experiences. As for Audrey, I am so very happy that her story appears to be a lab error.  FT
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline Mila

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Re: relapse after 1 year
« Reply #70 on: June 30, 2016, 02:49:05 am »
Great news for Audry!
I'm sure that eases some minds. Also its good to remember that when they say "97%" that means 3% are the other. Sucks to think it could be you.

It was a real eye opener talking to the Harvoni nurse as it made me realise that even though I am not in the first user group I am still essentially part of an experiment. Its strange to get my head around that as I am not a big fan of pills and don't necessarily have a trust of drug companies. Its been very reassuring today to read all of these forums and knowing that everybody here is experiencing it too. It seems each in our own ways.

So in advance...Thanks everyone for sharing. It really does make a difference.
~Mila
Infected probably 1977/78
1st diagnosed: 2009
UN-diagnosed: 2012
RE-diagnosed by new Dr 2015
naive treament
genome type: 1a
Viral count at start of Harvoni treatment: 8,090,000
AST/SG: 51
ALT: 71
F1-2

4 Week:
HCV RNA: NOT DETECTED
AST/SG: 31
ALT: 44

8 Week:
HCV RNA: NOT DETECTED
AST: 33
ALT: 45

Week 12:
No HepC detected repeat in 3 months

2 years:
non detected

Offline Philadelphia

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Re: relapse after 1 year
« Reply #71 on: June 30, 2016, 06:35:52 am »
My fingers are crossed that it is a mistake. Sounds promising!
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 audreywald

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Re: relapse after 1 year
« Reply #72 on: June 30, 2016, 12:00:39 pm »
How do I become friends with some of you?
 :P

Offline Mila

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Re: relapse after 1 year
« Reply #73 on: July 01, 2016, 04:13:51 pm »
click on their name and then add to buddy list I'm assuming.
Infected probably 1977/78
1st diagnosed: 2009
UN-diagnosed: 2012
RE-diagnosed by new Dr 2015
naive treament
genome type: 1a
Viral count at start of Harvoni treatment: 8,090,000
AST/SG: 51
ALT: 71
F1-2

4 Week:
HCV RNA: NOT DETECTED
AST/SG: 31
ALT: 44

8 Week:
HCV RNA: NOT DETECTED
AST: 33
ALT: 45

Week 12:
No HepC detected repeat in 3 months

2 years:
non detected

Offline dragonslayer

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Re: relapse after 1 year
« Reply #74 on: July 01, 2016, 06:14:48 pm »
Great friggin' news!!!!!!!!!!!!  So happy for you.   And, so happy for us!!!  Everybody, take a deep breath; it aint gonna come back to bite us after all..
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline morab

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Re: relapse after 1 year
« Reply #75 on: July 01, 2016, 07:06:52 pm »
fantastic news Audrey! I do believe we are all your friends!
You can go to a person's page by clicking on them, add to buddy list although I have not really figured out what that does.
Please keep us posted on how you are doing! I plan to follow this site for many years to come! This has been my go to place for several weeks now and a life saver as far as moral support!!!!
morab
3/2016 G 1a
Alt 84
Ast 62
Fibrosis score lab 0.66
quantitation 894,670
4/23/16 day 6, naive Harvoni 12 week treatment
5/27/16 week 4 lab results UNDETECTED AST 23 ALT17

Offline brie41

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Re: relapse after 1 year
« Reply #76 on: July 01, 2016, 07:13:48 pm »
Hi Audrey,

  Sometimes all we need is a chance, and I would say you got that!!!  I will be thinking positive thoughts that it was just a mistake and you are svr for good!!  Hang in there!  Brie
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 Bucky

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Re: relapse after 1 year
« Reply #77 on: July 03, 2016, 10:57:15 am »
Yeah
I was debating if I wanted to get tested at 24 months I guess I am more leaning on asking for a 2 year test now in light of this situation

Hello Lynn, How you doing?
I haven't been here in a while and was kinda stunned that a few people were relapsing after a year. I had complete Hepc labs at one year and there was no trace of it. When I see my Gastro in August (2 year mark PT) I am going to get another set of tests run. I don't anticipate a problem since my liver panels have been perfect since EOT.
Bucky 
I HAVE SLAYED THE DRAGON.....CURED SVR24!

Offline dragonslayer

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Re: relapse after 1 year
« Reply #78 on: July 03, 2016, 06:50:56 pm »
Hello Lynn, How you doing?
I haven't been here in a while and was kinda stunned that a few people were relapsing after a year. I had complete Hepc labs at one year and there was no trace of it. When I see my Gastro in August (2 year mark PT) I am going to get another set of tests run. I don't anticipate a problem since my liver panels have been perfect since EOT.
Bucky

Hey Bucky..... Well, Audrey isnt one of them since it turned out to be a false alarm.. Are there others on Harvoni reporting 1 yr delayed relapses?  I know that statistically, it happens, but only to the tune of about 1% or less.
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline dragonslayerinprogress

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Re: relapse after 1 year
« Reply #79 on: July 04, 2016, 03:46:48 am »
Crossing fingers and hoping for your results Audrey.
As far as the 1%....that is a lot if you do the math and how many people have the virus.
Geno 2b
dx in 1990, 52 years old
Origin: unsure. Might have been infected at birth
Tx Naive
Pre tx labs 12/7/15
VL 1,315,890 6.119
ALT 188
AST 161
Started tx Solvadi/Ribavirin on 1/19/16
4 weeks undetected
8 weeks undetected
12 weeks undetected
16 weeks undetected
20 weeks undetected
24 weeks...no testing
EOT 4 wks UNDETECTED
ALT 34
AST 42
EOT 8 wks- UNDETECTED
ALT 38
AST 50
Platelets 49

Offline Lynn K

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Re: relapse after 1 year
« Reply #80 on: July 04, 2016, 05:46:13 am »
Hello Lynn, How you doing?
I haven't been here in a while and was kinda stunned that a few people were relapsing after a year. I had complete Hepc labs at one year and there was no trace of it. When I see my Gastro in August (2 year mark PT) I am going to get another set of tests run. I don't anticipate a problem since my liver panels have been perfect since EOT.
Bucky

Hey Bucky how are you doing?

I was tested at 44 weeks post as it was time for my annual with my liver Doctor. I was still SVR my ALT and AST were both normal range, my AFP was just slightly above normal at 10 point something so lowest since it has been being tracked, and my platelets were up to 110.

As Dragonslayer said it does look like Audry thankfully was a false alarm due to a lab error. I think I would be looking for a lab technician to kick their butt

Best to you
Lynn
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 dragonslayer

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Re: relapse after 1 year
« Reply #81 on: July 04, 2016, 09:18:32 am »
Crossing fingers and hoping for your results Audrey.
As far as the 1%....that is a lot if you do the math and how many people have the virus.

This '1%' is an oft quoted number for which I havent found much treatment specific/genotype specific information.   Suffice it to say that for any given person, odds are very small that it will happen to them.  Seems odds for lab error may be higher than odds for delayed relapse!
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline Lynn K

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Re: relapse after 1 year
« Reply #82 on: July 04, 2016, 11:09:08 am »
I have seen the number that if you make 12 weeks SVR the odds of cure are 99.8% so wouldn't that lead to the thought 0.2% odds of relapse if SVR12 is acheived?

However statistical math and calculation of odds is not an area I know anything about.
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 dragonslayer

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Re: relapse after 1 year
« Reply #83 on: July 04, 2016, 03:50:59 pm »
I have seen the number that if you make 12 weeks SVR the odds of cure are 99.8% so wouldn't that lead to the thought 0.2% odds of relapse if SVR12 is acheived?

However statistical math and calculation of odds is not an area I know anything about.

Hi Lynn,

If you check the table in this article concerning Predictive value of SVR, http://www.journal-of-hepatology.eu/article/S0168-8278(13)60850-8/pdf, you see that 99.8% is the value given to  what I interpret to be the positive predictive value of SVR12 toward achieving SVR24...   

But if we're talking Late Relapse of a year or more, Im not seeing, at least in that oft quoted article (by me!  lol), any reference to delayed relapse ppv.

It does say in its conclusion that, "SVR12 has a 99.8% positive predictive value,
demonstrating the reliability of this time point for assessing a durable response."

But, are they using SVR24 as the end point, or does 'durable' mean for perpetuity?!  Maybe I missed it, but I dont think its clear in the article.
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline Lynn K

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Re: relapse after 1 year
« Reply #84 on: July 04, 2016, 04:29:57 pm »
I take durable to mean durable vs durable meaning 24 weeks.

However as we are early treaters how many many weeks post treatment are even the people from the clinical trials? Harvoni was only approved Oct 2013 just 2 years 9 months ago so even someone who received Harvoni then and for 8 weeks treatment would have finshed treatment about 130 weeks ago. Just not a lot of us out there yet to generate a lot of data
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 gnatcatcher

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Re: relapse after 1 year
« Reply #85 on: July 04, 2016, 04:36:17 pm »
Actually, the FDA approved Harvoni on October 10, 2014, so less than 1 year 9 months.
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm418365.htm
9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline Lynn K

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Re: relapse after 1 year
« Reply #86 on: July 04, 2016, 06:37:12 pm »
Yeah Gnatty my bad counting on fingers and toes lol

Yeah so I year 9 months give or take so just not a lot of data yet to be had for long term results
« Last Edit: July 04, 2016, 06:39:46 pm by Lynn K »
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 dragonslayer

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Re: relapse after 1 year
« Reply #87 on: July 04, 2016, 07:07:40 pm »
I take durable to mean durable vs durable meaning 24 weeks.

However as we are early treaters how many many weeks post treatment are even the people from the clinical trials? Harvoni was only approved Oct 2013 just 2 years 9 months ago so even someone who received Harvoni then and for 8 weeks treatment would have finshed treatment about 130 weeks ago. Just not a lot of us out there yet to generate a lot of data


Actually, it was Oct. 2014!  So, even fewer of us out there...

EDIT:   (Its really annoying that we cant delete posts!)

Nm this one; I see the correction has already been made!
« Last Edit: July 04, 2016, 07:09:39 pm by dragonslayer »
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline Lynn K

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Re: relapse after 1 year
« Reply #88 on: July 04, 2016, 09:51:33 pm »
Yeah my bad sorry about the wrong dates on my part

Hope everyone is having a great 4th of July
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 spitzbar

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Re: relapse after 1 year
« Reply #89 on: July 05, 2016, 11:41:21 am »
...laboratory errors are not uncommon...but an error showing a viral load of 744,000...how can that be.


...your name was inadvertently tagged with someone else's blood and tested


...retest should establish SVR or relapse


...blessings

Offline audreywald

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Re: relapse after 1 year
« Reply #90 on: July 08, 2016, 11:59:11 am »
I had the "definitive" blood test yesterday. Should know in a week or two. Could a lab have mixed up me and my husband? We have the same first initial as well as last name. His viral load was just about 744, 000 - just what one lab said mine was.

also, my husband is showing a lot of symptoms after only 7 years. But he was on/off drinking for many of those years. He is on Antabuse now, so drinking could kill him. He has not had a drink (I am sure   in close to a year. Could the disease progress that quickly in only 7 years with the periodic drinking? If anyone could give me some opinions (or facts) I would so much appreciate it. >:(   

Offline audreywald

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Re: relapse after 1 year
« Reply #91 on: July 08, 2016, 12:01:26 pm »
ps - I started Harvoni in January 2014. REALLY early.

Offline audreywald

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Re: relapse after 1 year
« Reply #92 on: July 08, 2016, 02:16:36 pm »
Just wanted to let you all know that I took my Harvoni every a.m. with my other meds. Also, NO chance of having been reinfected ; NO behavior that could have done that.

Does anyone still feel really crappy after a year post tx? I do. I really want to know about anyone else. I fade out at about 5p.m. and have no energy until the next day. But, as I said, kind of, my stress levels are through the roof. I wake up every morning and cry for a couple of hours (over my missing grandson) I cry if anyone talks harshly to me. My grandson's disappearance destroyed a lot of me. That and being so ill for so long seems to have taken away most of the person I was. Good health again would help a lot.

Offline AussieRosa

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Re: relapse after 1 year
« Reply #93 on: July 12, 2016, 11:16:09 pm »
Audrey, I'm so sorry to hear you've been going through so much. I can't imagine how I would cope with the disappearance of a close loved one. I just plain wouldn't cope, I know that much. Illness on top of the constant stress of that must really be taking its toll on you. My heart goes out to you. I hope and pray that you receive some good news soon.
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 audreywald

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Re: relapse after 1 year
« Reply #94 on: July 13, 2016, 04:35:41 pm »
Good news would sure be a nice change.  As for my grandson, I am not handling it. Some days I can handle all of this (health stuff included) some days (twice in the last week) I could not stop crying. All day. That scared me.

Offline audreywald

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Re: relapse after 1 year
« Reply #95 on: July 13, 2016, 05:35:14 pm »
good news. Lab error. I am at 0 viral load. :-)

Offline KimInTheForest

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Re: relapse after 1 year
« Reply #96 on: July 13, 2016, 05:40:28 pm »
good news. Lab error. I am at 0 viral load. :-)

FANTASTIC AUDREY!! Enjoy  8)
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 Philadelphia

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Re: relapse after 1 year
« Reply #97 on: July 13, 2016, 05:54:00 pm »
Woohoo!
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 Patty

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Re: relapse after 1 year
« Reply #98 on: July 13, 2016, 06:29:02 pm »
Audrey Hi,
My name is Patty. First I'm glad it was a lab mistake. Second I just finished a week ago and I'm in so much pain, but that's not why I'm here. I've learned that undetected means that the virus is to small to read by the instruments they have. So there is still some of the virus still floating around its just such a small amount that they can not detect it with their instruments. Which I believes means that eventual the virus will come back, when who knows, because it's a very slow moving virus. I do know the virus craves sugar so I try and stay away from that, and stress can be harmful. I did not have a shady past nothing wild to write home about, LoL. I was infected by a patient I worked on. I believe we all have the potential to relapse with time. Because the virus is never 100% gone, there are a few floating around, with that being said I'm glad hep-c is finally getting attention for research and cures. I was infected 2003 and was chronic, so I always had symptoms. But I was able to stay steady at stage 1 until my auto accident which took a tremendous toll on my body took me from stage 1 to 4 in just 2 years. So yes stress can have an impact. I was also drawn to your story because my brother one day just dropped off the face of the earth. For almost 2 yrs no contact, than one day we got a phone call, it was him. He had been following the Greatful Dead around on tour and when my dad made the trip from Va all the way across the country to Washington state to get him, he looked as though he had been in a concentration camp. But we had him back and with lots of love and counseling and Prayer he recovered. He now is married and has 4 beautiful children. So don't give up hope. It was many yrs ago this took place but feels like yesterday as I type this to you. You do have a lot to live for, and God is not done with you yet. Thank you for sharing your story, I'm having a hard time coming off Harvoni and you made me forget my pain for a little. Maybe that's your purpose, to be an light and encourager to all of us on here. We all have story's and valleys we had to go thru. But having someone who has gone through it to helps give hope. And today I really needed hope. We are your friends, we lift each other up, give advise and that is so important. To know we're not alone. Thank you. Thank you for giving me hope
Patty
Geno type 1a
Fibrosis stage 4 severe
Infected by a patient I worked on 2003
Went thru Interferon combo for almost a yr in 2004 was taken off because hemmorage behind my eye
Harvoni 12 week treatment startered 4-14-2016
1 yr later Hep-C undetected

Offline dragonslayer

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Re: relapse after 1 year
« Reply #99 on: July 13, 2016, 06:30:26 pm »
Patty, just to correct the record, HCV is NOT a slow moving virus; its a very rapidly replicating virus, which means that being undetected in two subsequent blood test is a pretty good indication that the virus is not vital and will cause no problems down the road..   In order to survive, this virus must replicate, and it does so rapidly.  It doesnt hang out in small numbers waiting to attack.. Just doesnt work that way.

What's slow is usually the progression  of liver disease which results from the virus...

Hope I cleared this up for you.
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline Patty

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Re: relapse after 1 year
« Reply #100 on: July 13, 2016, 06:39:42 pm »
Patty, just to correct the record, HCV is NOT a slow moving virus; its a very rapidly replicating virus, which means that being undetected in two subsequent blood test is a pretty good indication that the virus is not vital and will cause no problems down the road..   In order to survive, this virus must replicate, and it does so rapidly.  It doesnt hang out in small numbers waiting to attack.. Just doesnt work that way.

What's slow is usually the progression  of liver disease which results from the virus...

Hope I cleared this up for you.


Dragonslayer

Dragonslayer,
 You are correct, I miss quoted. Thank you for clearing that up. Virus is fast moving, the damage is slow moving.
Patty
Geno type 1a
Fibrosis stage 4 severe
Infected by a patient I worked on 2003
Went thru Interferon combo for almost a yr in 2004 was taken off because hemmorage behind my eye
Harvoni 12 week treatment startered 4-14-2016
1 yr later Hep-C undetected

Offline I fightis thetitis

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Re: relapse after 1 year
« Reply #101 on: July 13, 2016, 06:54:00 pm »
Hi Patty,

Glad to hear you are feeling better. And in other good news, the Dr and Hep C Nurse's I have been in contact with have many patients that have been cured for several years. First, some have cleared the virus on their own, then others from Peg/Riba (small number) and more recently last two years DAA's like Harvoni.

Those professionals (and new data) specifically state there is a cure.
I'm told that 24 weeks SVR is the gold standard and at my GI's office there is no record of relapse after 36 weeks (non compliant patient) going back 2+ decades. 
Clear the virus for a year and safe to say your immune system, along with help from the drugs, = HCV cured. YES!
M59  56@start of TX. date infected:1976
diagnosed 1997 - asymtomatic
Genotype 1a
AST 111 -ALT 124 - AFP -89
Viral Load 1900000 - Log 6.28
Fibro Test F4 ActiTest A3
Harvoni 24 wks - start date 11/24/15

6 Week Labs VL Undetected!
104 weeks EOT Undetected.

8/25/17 Fibrosure score 80 = F4
11/10/17 Fibroscan 7.5 mean 1.6 m/s = F2
8/2018 Ultra sound normal.

Offline Patty

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Re: relapse after 1 year
« Reply #102 on: July 13, 2016, 07:30:57 pm »
I fightis thetitis,

Congrats, on being cured !! I'm sorry I can't say I feel better just yet. In fact I feel worst than I did when I started, but I keep hoping I wake up tomr feeling better. The Professionals at Tampa General transplant and Heptology center told me, we hope we can help, but your a tricky case, because you have no immune system. So we are not all the same and we can not all expect the same results, but here's to trying !! YES !
Geno type 1a
Fibrosis stage 4 severe
Infected by a patient I worked on 2003
Went thru Interferon combo for almost a yr in 2004 was taken off because hemmorage behind my eye
Harvoni 12 week treatment startered 4-14-2016
1 yr later Hep-C undetected

Offline Lynn K

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Re: relapse after 1 year
« Reply #103 on: July 14, 2016, 02:28:28 am »
Hi Patty

Below detectable means ther may or there may not be some virus remaining lower than the tests ability to detect that is why we have to wait 12 weeks post treatment to be declared cured. In those 12 weeks if there was a very small amount of virus remaining it is possible the virus could come roaring back and v eat pre treatment levels in that sort period of time. If it is not back in 12 weeks the idea is it likely (99.8%) it won't be coming back.

The experts do believe that if we make it to SVR 12 and better yet SVR 24 and beyond that in fact we are cured and we do not have the hep c virus in our bodies. That the virus truly is 100% gone.

Virus populations grow exponentially so if there was any virus it would very quickly repopulate.



Awesome news congrats Audrey!!!! I think i would be looking to find that lab tech and give them a piece of my mind but I don't have a lot of mind to spare lol!
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 AussieRosa

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Re: relapse after 1 year
« Reply #104 on: July 14, 2016, 12:12:18 pm »
Congratulations, Audrey. Some great news at last.
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 audreywald

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Re: relapse after 1 year
« Reply #105 on: July 24, 2016, 02:49:05 pm »
I need you guys opinion very much. I contacted an attorney about my "lab results" that showed the virus had come back, and then waited for new lab results after they decided to take a new viral load. My best friend said this is bad karma, I think it is just and fair. A carrot was dangled in my face and it said "you're well." 6 months later the carrot was taken back that said, oops, some error, you're not well." At my age it was like death sentence cancelled, death sentence reinstated, death sentence cancelled again. Is it wrong to hold people accountable who you are trusting to tell you by their expertise if you are cured or not of a life threatening disease.

Plus, the lawyer won't take it if he thinks there is no chance of winning. Because no money up front is required.

And I was scared to death, my h8usband too, and I needlessly scared so many of you.

So please, opinions needed.

Ty - love you all, Audrey

Offline AllShookUp

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Re: relapse after 1 year
« Reply #106 on: July 24, 2016, 04:16:15 pm »
IMO, I think your friend is right. Just let it go. Be happy that you that you got rid the of virus.
The lawyer is dangling a carrot. Bringing in a lawyer is just going to cause you anxiety. Lawyer will get lion's share of settlement in the unlikely event that he/she wins.
Male - BabyBoomer
1995 - diagnosed HCV
2002 - Peg + Riba - quit after 5 weeks severe anemia
2015 Nov -start 12 weeks Harvoni +Riba + Procrit
Gen 1b - VL 1,500,000 -ALT93-AST143
Comp cirrhosis - enlarged spleen - platelets 35
Week 5 of Tx - HCV undetected - ALT/AST normal
End Week 12 of Tx - HCV UD - ALT/AST normal
Jan. 25, 2016 EOT
April 4, 2016 - SVR10 UD - ALT/AST normal
May 5, 2016 - SVR14 UD - ALT/AST normal
Aug 5, 2016 - SVR28 UD - ALT/AST normal

Offline FutureThinker

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Re: relapse after 1 year
« Reply #107 on: July 24, 2016, 04:58:22 pm »
Hey Audrey, I understand your wanting to do something about this; it scared you and your family to death, and also all of us who read about it!

Before going to an attorney, perhaps reviewing this lab's policies on complaints, errors, etc. would be helpful. You can probably find it on their website somewhere; if not,  by contacting the lab's manager.  And maybe instead of filing a lawsuit, file a formal complaint with the company.  They must have a process for complaints and that may be the way you can obtain some satisfaction in this wrong.  This lab obviously needs to review their procedures, at the very least, if not also reprimand the lab tech.

I had a lab order once for general annual bloodwork in which the tech failed to get all the ordered tests. This was a fasting draw, so I wasn't too happy! I contacted the manager to formally complain, and they readily agreed to another draw at no charge (of course) and were very apologetic for the error.  And, I have to say I never saw that tech in that lab again...... I made it very clear I would never let her perform my labs again. I knew I'd be using this lab in the future due to my hepatologist's office preferring them, so this was the route I took.

Hope this helps, and again, we are all so very happy this was an error!! FT
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline Mike716

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Re: relapse after 1 year
« Reply #108 on: July 30, 2016, 04:45:05 am »
I would not be surprised if you went from stage 3 to stage 2 or 1 (I went from nearly a 3 to a 0 when I relapsed from PEG+RBV)

The editorial commentary that dragonslayer posted a link to (http://jid.oxfordjournals.org/content/early/2013/11/14/infdis.jit543.full.pdf) says:

"It is likely that we will be able to cure
almost all patients with HCV infection
within the next 3 years, but we might
only heal the livers in some of them. A
recent long-term analysis found that only
about 50% of cirrhotic patients experi-
enced a reversal of cirrhosis after achiev-
ing SVR, while a significant number of
patients achieving SVR in the absence of
cirrhosis still progressed to cirrhosis
despite being cured of HCV infection.(20)

20. Poynard T, Moussalli J, Munteanu M, et al.
Slow regression of liver fibrosis presumed by
repeated biomarkers after virological cure in
patients with chronic hepatitis C. J Hepatol
2013; 59:675–83."

Are you certain that your fibrosis reverted after Tx to an earlier stage? This goes against most available data. What tests were used? Were they truly comparable, especially over time?

M.
Diag. 2008: HCV geno 1a
Biopsy 2008: F1-F2
Fibroscan 2012: F2-F3
Fibrotest 2015: F4 (& AST 150)
Tx 2015: Sovaldi+Olysio, 12 wks.
EOT+3mos. VL: UND
EOT+15 mos. VL: UND

Offline Mike716

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Re: relapse after 1 year
« Reply #109 on: July 30, 2016, 04:51:50 am »
HCV is NOT a slow moving virus; its a very rapidly replicating virus, which means that being undetected in two subsequent blood test is a pretty good indication that the virus is not vital and will cause no problems down the road..   In order to survive, this virus must replicate, and it does so rapidly.  It doesnt hang out in small numbers waiting to attack.. Just doesnt work that way.

The editorial commentary that you posted a link to (http://jid.oxfordjournals.org/content/early/2013/11/14/infdis.jit543.full.pdf) says:

"An antiviral might lead to a sub-
stantial fitness cost to a virus, which
means that only very unfit virus might be
able to resist elimination, which in turn
requires the mutated or selected unfit
virus to revert to higher replicative capac-
ity, which might take several months or
years."

and

"harbored virus might have an intrinsically low
replicative activity, making it less vulnerable
to antiviral pharmaceuticals."

Is the author wrong?

M.
Diag. 2008: HCV geno 1a
Biopsy 2008: F1-F2
Fibroscan 2012: F2-F3
Fibrotest 2015: F4 (& AST 150)
Tx 2015: Sovaldi+Olysio, 12 wks.
EOT+3mos. VL: UND
EOT+15 mos. VL: UND

Offline dragonslayer

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Re: relapse after 1 year
« Reply #110 on: July 30, 2016, 09:06:05 am »
The editorial commentary that you posted a link to (http://jid.oxfordjournals.org/content/early/2013/11/14/infdis.jit543.full.pdf) says:

"An antiviral might lead to a sub-
stantial fitness cost to a virus, which
means that only very unfit virus might be
able to resist elimination, which in turn
requires the mutated or selected unfit
virus to revert to higher replicative capac-
ity, which might take several months or
years."

and

"harbored virus might have an intrinsically low
replicative activity, making it less vulnerable
to antiviral pharmaceuticals."

Is the author wrong?

and:

" A recent long-term analysis found that only
about 50% of cirrhotic patients experi-
enced a reversal of cirrhosis after achiev-
ing SVR, while a significant number of
patients achieving SVR in the absence of
cirrhosis still progressed to cirrhosis
despite being cured of HCV infection."



M.

No, Im not saying the author is wrong, but insofar as this could be an explanation for delayed relapse, it happens in an extraordinarily small number of people.  In addition, the article was published in 11/13, a full year before Harvoni was approved, and before other contemporary DAAs were in wide circulation and, even so, it was offered as a hypothesis only.  Words like 'might' fill the text.  The landscape is changing fast, and I wouldnt cling too hard to any one explanation for unusual phenomena at this point.

As for the quote regarding cirrhosis, this was very troubling to me when I first read it.  The idea that a non cirrhotic liver will still  progress to cirrhosis post SVR in a 'significant'  number of cases sounded beyond fatalistic and more than a little depressing.  I dont have enough specific knowledge to comment on this, but we know the liver is one of the few organs that will regenerate in the absence of the initial stressor.   Why some dont experience this, I cannot explain.
« Last Edit: July 30, 2016, 09:12:15 am by dragonslayer »
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline Lynn K

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Re: relapse after 1 year
« Reply #111 on: July 30, 2016, 01:40:36 pm »
I have said from time to time hep c is a slow moving virus in that it takes many years to cause liver damage in most cases however like any virus it replicates in an exponential maner which is why when treatment fails the virus returns with a vengeance.
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 Lynn K

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Re: relapse after 1 year
« Reply #112 on: July 30, 2016, 01:46:06 pm »
Here is more info from another hep c page about reversibility of cirrhosis

"HectorSF


Alimentary Pharmacology & Therapeutics Review Article: The Reversibility of Cirrhosis

A. A. Sohrabpour; M. Mohamadnejad; R. Malekzadeh
Aliment Pharmacol Ther. 2012;36(9):824-832.

Abstract and Introduction
Abstract

Background Cirrhosis is the end result of many types of chronic liver diseases. Recent developments in the understanding of the process of hepatic fibrogenesis have revealed that the process is a dynamic one and a capacity for recovery from any degree of fibrosis including those associated with cirrhosis is plausible.
Aim To review current evidence of histopathological reversibility following drug therapy of more common aetiologies of cirrhosis.

Methods
A PubMed search was performed and the evidence for histopathological regression of advanced fibrosis/cirrhosis following drug therapy was reviewed as of the end of February 2012.

Results
There is abundant clinical evidence in support of the idea of the reversibility of cirrhosis in patients with different aetiologies of advanced hepatic disease including viral, autoimmune and metabolic/infiltrative liver disease.

Conclusions The concept of cirrhosis has changed from being a form of static and irreversible entity to a dynamic and reversible diseases stage. Novel therapeutic strategies are under investigation to target specific steps in the process of fibrogenesis with the aim of reversing advanced fibrosis/cirrhosis.

Cirrhosis, also know as "stage 4 liver disease", can be classified into sub-stages. The chance for reversibility of cirrhosis declines as the liver goes through more advanced substages of cirrhosis.

"Compensated cirrhosis"
May have no complications or symptoms at all. Blood tests may be normal, but there is usually a low platelet count (12 mmHg) portal hypertension."
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 Mike716

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Re: relapse after 1 year
« Reply #113 on: July 30, 2016, 03:45:03 pm »
HI, LYNN.

Yes, there are papers on both sides of the subject. And I believe, from all that I've read on it, that there are at least as many cases of worsening as there are of improvement. Or we could say it the other way round. It's a case of whether the glass is half full or half empty.

My hepatologist in the large hospital I belong to in Buenos Aires, which has the largest hepatology department in Argentina and treats the most cases of hep-c, says that of the hundreds of cases he has treated in the past ten years he has seen very few cases of improvement, that is, reversal of fibrosis grade, and those primarily in patients who were in an early stage (F0 - F3) before treatment. Once cirrhotic they remain cirrhotic, according to him. Which is why the hospital's standard protocol is to continue blood tests and ultrasound for the life of the patient, not only to watch for incipient HCC but because of the ongoing risk of portal hypertension, varices, and hemorrhage.

We are talking here about people who have been cleared of the virus, or at least are UND for over a year, later developing esophageal varices that bleed as well as other consequences of portal hypertension and cirrhosis (ascites, low platelets, low prothrombin, etc.).

Too downbeat? Perhaps. But it's better, in my opinion, to be prepared for the worst and be happily surprised when it doesn't happen, than to live in a fool's paradise. Denying reality can result in insufficient surveillance. That is the danger of thinking that once you are cured of the virus nothing further can go wrong with your liver.

M.
Diag. 2008: HCV geno 1a
Biopsy 2008: F1-F2
Fibroscan 2012: F2-F3
Fibrotest 2015: F4 (& AST 150)
Tx 2015: Sovaldi+Olysio, 12 wks.
EOT+3mos. VL: UND
EOT+15 mos. VL: UND

Offline Lynn K

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Re: relapse after 1 year
« Reply #114 on: July 30, 2016, 05:32:19 pm »
Hi Mike

I prefer to be glass half full I have had cirrhosis for 8.5 years at this time so I will of course continue with my every 6 months blood testing and abdominal ultrasounds plus my annual upper endoscopies and specialist visit and hope for the best. My main concern right now is HCC which will remain at elevated risk for me and others like me with cirrhosis. 

Best to you 
Lynn
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 Mike716

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  • Here's looking at you. . .
Re: relapse after 1 year
« Reply #115 on: July 30, 2016, 08:19:25 pm »
Lynn-

I've got to hand it to you, you're doing even more than I am. I progressed to cirrhosis also before Tx-ing, and I'm continuing with the blood tests and the unltrasound scans, but my hep MD hasn't said anything about an upper-endoscopy lately. Thanks for reminding me.

I agree with you, HCC is a very serious concern. It was brought home to me just how serious when my girlfriend here in B.A. passed away in April from liver cancer. Maybe you knew that. She didn't have HCV or even cirrhosis, as far as we knew, but somehow a carcinoma got started in her liver and it grew so fast that there was no treatment that could save her. Horrible, and very scary for us heppers. Considering how fast her liver cancer grew, I wonder if bi-annual US scans are enough. The whole thing has me very worried. I mean, she didn't have a chance, you know? In January she was fine, still working, no symptoms yet, and in April she was gone.

This is why I think that telling people they can expect fibrosis regression once they're cured of the virus isn't a good idea. It breeds complacency. Any one who got to an advanced stage of fibrosis or to cirrhosis before a successful Tx should remain highly vigilant and not act as if now they've got nothing to worry about.

Don't you agree?

Mike
Diag. 2008: HCV geno 1a
Biopsy 2008: F1-F2
Fibroscan 2012: F2-F3
Fibrotest 2015: F4 (& AST 150)
Tx 2015: Sovaldi+Olysio, 12 wks.
EOT+3mos. VL: UND
EOT+15 mos. VL: UND

Offline Lynn K

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Re: relapse after 1 year
« Reply #116 on: July 30, 2016, 08:31:08 pm »
I believe in being optimistic but realistic.

I have the annual endoscopies because I previously had grade 3 varicies that required banding back in 2012

So sorry to hear about your girl friend. We lost a member her recently also to HCC less than a year after she was cured of hep  c.

But again I prefer to look to the future with courage and optimism.
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 Mike716

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  • Here's looking at you. . .
Re: relapse after 1 year
« Reply #117 on: July 31, 2016, 12:15:31 am »
Lynn-

Quote
I have the annual endoscopies because I previously had grade 3 varicies that required banding back in 2012

I didn't know that. You must have suffered a lot and been scared.

Quote
So sorry to hear about your girl friend.

Thank you.

Quote
We lost a member here recently also to HCC less than a year after she was cured of hep  c.

Was she diagnosed with HCC before she treated the hep-c?


By the way, your profile says:

24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, NOT DETECTED!

Didn't you have an EOT+12mos. VL (PCR) done? You only mention a 44 weeks Fibroscan.

Cheers.

Mike
Diag. 2008: HCV geno 1a
Biopsy 2008: F1-F2
Fibroscan 2012: F2-F3
Fibrotest 2015: F4 (& AST 150)
Tx 2015: Sovaldi+Olysio, 12 wks.
EOT+3mos. VL: UND
EOT+15 mos. VL: UND

Offline Lynn K

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  • Get tested, get treated, get cured, fight Hep c!
Re: relapse after 1 year
« Reply #118 on: July 31, 2016, 12:59:01 am »
Something showed up on her 6 month post treatment ultrasound last fall she passed away in January or February I think.

My annual visit was at 44 weeks post so we did all the normal stuff and I asked for a viral load test at that time 44 weeks not detected.

About the varicies I had an upper endoscopy once a month for 4 months for the bandings. My best guess is I have had a total of 12 give or take over time from the initial one with grade 1. Since the bandings I haven't had any reoccurrence.
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 Mike716

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  • Posts: 15
  • Here's looking at you. . .
Re: relapse after 1 year
« Reply #119 on: July 31, 2016, 01:37:54 am »
Lynn-

Quote
Something showed up on her 6 month post treatment ultrasound last fall

I'm surprised she didn't have a heart attack right then and there.

Quote
she passed away in January or February I think.

Same time-frame as my girlfriend. HCC doesn't give you a chance. Did they try any sort of therapy for the cancer, or did they figure it was pointless because it was already too far advanced when they found it?

Quote
My annual visit was at 44 weeks post so we did all the normal stuff and I asked for a viral load test at that time 44 weeks not detected.

Maybe you could edit your profile to make that clear. As it is, it sounds like you are saying undetected by Fibroscan.

Quote
My best guess is I have had a total of 12 give or take over time from the initial one with grade 1.

12 endoscopies? You are a very brave person. I bet you did them without a general anesthetic, too.

Quote
Since the bandings I haven't had any reoccurrence.

You've been lucky. I knew someone who died of hemorrhaging varices. He otherwise had more or less compensated cirrhosis, except of course for platelets and prothrombin time, which were way down. The hospital tried everything but couldn't stop the bleeding (or so they claimed). This was the main reason i decided to finally treat when I did. My platelets were dropping fast (in one year, 2014/2015, from 145k to 80k) and my coagulation factors had also started down.

By the way, I meant to ask you, what's the story with all your ultrasound tests. Did they detect portal hypertension early? What was the blood flow in your portal vein at different stages, like when the varices appeared, do you know? (Sorry to be so nosey but this stuff interests me, as ultrasound has been my primary test and the only ongoing one)

M.
Diag. 2008: HCV geno 1a
Biopsy 2008: F1-F2
Fibroscan 2012: F2-F3
Fibrotest 2015: F4 (& AST 150)
Tx 2015: Sovaldi+Olysio, 12 wks.
EOT+3mos. VL: UND
EOT+15 mos. VL: UND

Offline Mike716

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  • Here's looking at you. . .
Re: relapse after 1 year
« Reply #120 on: July 31, 2016, 02:33:14 am »
dragonslayer-

Quote
Im not saying the author is wrong, but insofar as this could be an explanation for delayed relapse, it happens in an extraordinarily small number of people.

That remains to be seen. The study that the editorial refers to had people relapsing as long as 6.5 years post-EOT, and that was still when they were treating with INF/RBV, which doesn't exert anywhere near as much pressure on the virus to mutate as the DAAs. I think we will have to wait and see just what the relapse rates are with the DAAs. From the reaction of the nurse at Gilead, which someone posted here somewhere, relapse after Harvoni was not negligible.

One thing that worries me is that it no longer seems that the time it takes the variants to revert to wild-type is as short as originally thought. This is very worrying as it could be getting longer as the treatment meds become more specific. We could end up turning HCV into a stealth virus. This is always a danger when trying to cure virus infections with chemicals, and these new ones aren't beeing administered with much care (knowledge about outcomes). I'd like to see more money going into research towards a vaccine.

I always have in the back of my mind some papers I read a few years ago about new epidemics of old diseases that had been thought to be conquered, like tuberculosis and pneumonia. The indiscriminate application of pathogen-specific antibiotics finally drove the bacteria involved into becoming so resistant that there are now strains that resist all antibiotics, creating a new epidemic. Microbes don't sit around waiting to be eliminated. They fight back.

Quote
In addition, the article was published in 11/13, a full year before Harvoni was approved, and before other contemporary DAAs were in wide circulation and, even so, it was offered as a hypothesis only.  Words like 'might' fill the text.  The landscape is changing fast, and I wouldnt cling too hard to any one explanation for unusual phenomena at this point.

Perhaps. But there has to be some explanation why some people relapse, and as long as 6.5 years after Tx (INF/RBV).

Sooner or later modern medicine is going to inadvertently create a microbe, virus or bacteria, that is unbeatable and which decimates populations. It has happened before in history, at various times and from various causes.

Quote
The idea that a non cirrhotic liver will still  progress to cirrhosis post SVR in a 'significant'  number of cases sounded beyond fatalistic and more than a little depressing.  I dont have enough specific knowledge to comment on this, but we know the liver is one of the few organs that will regenerate in the absence of the initial stressor.   Why some don't experience this, I cannot explain.

I'd like to see some well-acquired data on this issue myself. And some attempts at an explanation of the mechanism. Because if there is no longer any HCV killing hepatocytes, what is continuing to kill them? Although to tell you the truth, what with the unreliability of all the fibrosis tests devised so far (except perhaps for MRE), it's hard to trust the supposed cases of worsening after cure.

I'm waiting for a serious book about HCV in all its facets and on all these issues to date.

M.
Diag. 2008: HCV geno 1a
Biopsy 2008: F1-F2
Fibroscan 2012: F2-F3
Fibrotest 2015: F4 (& AST 150)
Tx 2015: Sovaldi+Olysio, 12 wks.
EOT+3mos. VL: UND
EOT+15 mos. VL: UND

Offline jakas

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Re: relapse after 1 year
« Reply #121 on: August 02, 2016, 07:30:17 am »
I think this thread should be deleted. The topic was a false alarm.

https://www.hepmag.com/blog/hepatitis-c-treatment-svr
« Last Edit: August 02, 2016, 07:34:11 am by jakas »
M/57 yrs.
Contracted (Unknown) 10-20-30 yrs back ??
Treatment Naive
Geno 1a&1b
VL  17+ million
ALT 200+, AST 170+
Fibroscan F4 ( 26+ kpa ) on 8th Dec. 2105
Started Tx 11th Dec.2015 ( 12 wks. Gilead Harvoni)
7/1/2016 :Viral Load|<25 UND.
23/1/2016: ALT 34 , AST 35, ALP 143
8 week NO labs done
EOT:03.03.2016 ( 84 pills eaten )
ALT 26, ALP 124, BIL .54
V/L <25 UND E.O.T.
4 weeks E.O.T. V/L UND::: SVR 4
SVR 12 and  SVR 24 on 16/8/16
Fibro 24.5kpa 23/05/16
SVR 63 05/17
Fibro 17.03.2020 kpa 6.3

Offline dragonslayer

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Re: relapse after 1 year
« Reply #122 on: August 02, 2016, 08:39:57 am »
I think this thread should be deleted. The topic was a false alarm.

https://www.hepmag.com/blog/hepatitis-c-treatment-svr

I disagree.   While its true that the original post reflected a test which turned out to be invalid, nevertheless, there is a lot of valuable information and linked data contained herein.  Why lose it?!
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline Mike716

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  • Here's looking at you. . .
Re: relapse after 1 year
« Reply #123 on: August 02, 2016, 08:50:49 am »
jakas-
Quote
I think this thread should be deleted. The topic was a false alarm.

I agree with dragonslayer.

What's more, I cannot comprehend how you or anyone else could suggest deleting a thread with 119 replies in it and in which many people have gone to great expense in time and energy to discuss what is probably the major issue - relapse - in this forum (PostHepatitis C Treatment).

Calling for the deletion of other people's work is an ugly thing to have done. It indicates a selfishness that is totally out of place in an open and collaborative forum.

Rather than deleting my work and that of all the other contributors to this thread, I would much prefer to see you deleted for your ugly, selfish, and undemocratic suggestion.

M.
Diag. 2008: HCV geno 1a
Biopsy 2008: F1-F2
Fibroscan 2012: F2-F3
Fibrotest 2015: F4 (& AST 150)
Tx 2015: Sovaldi+Olysio, 12 wks.
EOT+3mos. VL: UND
EOT+15 mos. VL: UND

Offline mollythedog

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  • Posts: 36
Re: relapse after 1 year
« Reply #124 on: August 02, 2016, 11:40:33 am »
Reading through the discussions on this thread, I remember when it was started, I thought it might be helpful to add my results.
2012-diagnosed hcv, via single episode of ascites. Varices B2. Platelets 33k, ast alt slightly high.
Decompensated cirrhosis, F4, liver covered in nodules.
July 2013 - diagnosed hcv 3 lesions.
August 2013 - chemo-embolisation partial success.
September varices stapled. Total blood screening, cat scans and mag. res.
October 2013 - Liver transplant. 5 cancerous lesions found.
December 2013 - recurrence of hcv alt/ast 280/350 leucocytes 1600 platelets 70k
June 2014 F1 A1
November 2014 F4 confirmed 3 times over 8 months
March 2015 VL 10 m. Treatment sov/olysio ribavirin. 12 was. Relapse at 12 weeks EOT.
October 2015  VL 5 m. F4 Retreatment sov daklinza ribavirin 24 wks
July 2016 VL undetected 15 weeks EOT.
Magnetic resonance plus fibroscan F1 ast alt 30/17 platelets 118k.
From F4 to F1
Next VL be October 13.
Hard to believe at first but feeling great. Best wishes to all.   Mollythedog.

Offline mollythedog

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Re: relapse after 1 year
« Reply #125 on: August 02, 2016, 11:42:18 am »
Correction. July 2013 diagnosed HCC


Offline KimInTheForest

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  • Believe in yourself
Re: relapse after 1 year
« Reply #126 on: August 02, 2016, 11:50:45 am »
From F4 to F1
Next VL be October 13.
Hard to believe at first but feeling great. Best wishes to all.   Mollythedog.

From F4 to F1 - WOW! That's great Molly. Congrats! :)

kim
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 FutureThinker

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  • Onward and upward!
Re: relapse after 1 year
« Reply #127 on: August 02, 2016, 12:06:55 pm »
W O W
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline FutureThinker

  • Member
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  • Onward and upward!
Re: relapse after 1 year
« Reply #128 on: August 02, 2016, 12:13:14 pm »
Sorry, going to try my post again........ W O W is all I can say, Molly!!!!!! Yours is an incredible story and thank you for sharing it with us. We're all just going to have to wait to see how this new DAA treatment works out, and we won't know for a while. I think there is good chance that the whole protocol will be different in the next 2 years or so. Lots of research still going on, and so many more people being treated, so we are all going to have to "stay tuned" to the medical community to see what all the data shows in the years to come.

We are the pioneers.  FT 
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline jakas

  • Member
  • Posts: 265
Re: relapse after 1 year
« Reply #129 on: August 02, 2016, 02:51:00 pm »
jakas-
I agree with dragonslayer.

What's more, I cannot comprehend how you or anyone else could suggest deleting a thread with 119 replies in it and in which many people have gone to great expense in time and energy to discuss what is probably the major issue - relapse - in this forum (PostHepatitis C Treatment).

Calling for the deletion of other people's work is an ugly thing to have done. It indicates a selfishness that is totally out of place in an open and collaborative forum.
Tell the moderator to change the title OF THE THREAD, try a search on google for SVR 12 AND RELAPSE
OTHERS PEOPLES WORK i VALUE but not THIS FALSE alarm
Rather than deleting my work and that of all the other contributors to this thread, I would much prefer to see you deleted for your ugly, selfish, and undemocratic suggestion.

M.
Tell the moderator to change the title OF THE THREAD, try a search on google for SVR 12 AND RELAPSE leads you straight here. I did not believe this thread title from when posted.
OTHERS PEOPLES WORK i VALUE but not THIS FALSE alarm DONT YOU REALISE the HARM its done COME ON, wake up !!!
LOL AND i DONT MIND BEING BANNED FROM THIS SITE btw you have 11 posts here thanks for them anyway. Bye
« Last Edit: August 02, 2016, 02:53:03 pm by jakas »
M/57 yrs.
Contracted (Unknown) 10-20-30 yrs back ??
Treatment Naive
Geno 1a&1b
VL  17+ million
ALT 200+, AST 170+
Fibroscan F4 ( 26+ kpa ) on 8th Dec. 2105
Started Tx 11th Dec.2015 ( 12 wks. Gilead Harvoni)
7/1/2016 :Viral Load|<25 UND.
23/1/2016: ALT 34 , AST 35, ALP 143
8 week NO labs done
EOT:03.03.2016 ( 84 pills eaten )
ALT 26, ALP 124, BIL .54
V/L <25 UND E.O.T.
4 weeks E.O.T. V/L UND::: SVR 4
SVR 12 and  SVR 24 on 16/8/16
Fibro 24.5kpa 23/05/16
SVR 63 05/17
Fibro 17.03.2020 kpa 6.3

Offline Lynn K

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  • Member
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  • Get tested, get treated, get cured, fight Hep c!
Re: relapse after 1 year
« Reply #130 on: August 02, 2016, 03:23:27 pm »
Ok folks if you recall our general forum rules

Forums, a round-the-clock discussion area for people who have Hepatitis B, C or a co-infection, their friends and family and others with questions about hepatitis and liver health. Check in frequently to read what others have to say, post your comments, and hopefully learn more about how you can reach your own health goals.

Privacy Warning: Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.
The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.
All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.
Product advertisement (including links); banners; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from the HEP Forum Moderators.

As you see we do not delete posts except on the occasions they are either an attempt to do something illegal like sell meds for an example , spam the forum or are personally abusive and obviously offensive.

That is why we say think before you post.

While I understand your concern about the title jakas it is what it is. If you look through the other threads in the forum I am sure you will find other examples of titles that could have been better chosen especially in hindsight like the title of this thread.
« Last Edit: August 03, 2016, 04:04:44 am by Lynn K »
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 Mugwump

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  • Posts: 778
  • My number of posts means nothing, piscor ergo sum!
Re: relapse after 1 year
« Reply #131 on: August 02, 2016, 11:52:53 pm »
Lynn I hope some read the thread because of the title. What the lesson here is that pcr testing can be wrong! All it takes is a very small bit of contamination and it does happen. Very important lesson not to panic if you are weakly detected and retesting is paramount.

Cheers to you for the pain the mistaken test put you through and we all need to keep our spirits up when this sort of thing happens.

All the best to you Audrey and many happy HCV free years.

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

Offline Lynn K

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  • Member
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  • Get tested, get treated, get cured, fight Hep c!
Re: relapse after 1 year
« Reply #132 on: August 03, 2016, 12:25:33 am »
Thanks Mugwump

That is exactly why we do not need to delete or otherwise modify this post
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 mollythedog

  • Member
  • Posts: 36
Re: relapse after 1 year
« Reply #133 on: August 03, 2016, 04:00:30 am »
Bello Lynn, Jakas, Mike, Mugwump et al,
I've written on this forum a lot and learned a lot more than Io wrote. I read all available info, studies, statistics etc. available via the links provided by diligent members. When I was VL be undetected 15 weeks I didn't believe it. Certain I had RAVs and that I was untreatable, one failed treatment already. My days were numbered. My first reaction was anger
Unexplainable anger and resentment. On hindsight I realise it was post by traumatic stress. This pathology is so stressful that while we're trying to slay the dragon we have a high adrenalin level and then suddenly pffffffff it's disappeared. Of course it's hard to believe!!! I still don't know whether or not being so informed and knowledgeable regarding hcv is a positive thing for everyone. Personally it was one way of fighting back. But the stress but caused by a realistic awareness of not being cured (again) was enormous. I'm still feeling disoriented regarding my future. Testing is a must for me due to the transplant and life long immune suppression. My advice for whatever it may be worth, I s to keep as calm as you can. Take time out NOT to think about the scientific aspects. We're not specialists or even doctors, some are nurses perhaps but it's so easy to panic over things which cannot happen but our logical reasoning tells us they could. It's more complicated than we think. My specialist proved to be right so many times when reason told me he was either wrong or underestimating. It's marvellous to take time out. I often forget I am Undetected. My blood work is now perfect and I abound with energy and not underlying stress induced adrenalin. Relapse? I doubt it but if it happens I'll go back on the battlefield.
Molly

Offline JimmyK

  • Member
  • Posts: 18
Re: relapse after 1 year
« Reply #134 on: August 03, 2016, 07:50:50 am »
Greetings,

I have been away from this Forum for quite a few months. I started reading again this morning early and came across this thread. Started at the first post and read all the way through.

I have to tell you, the entire thread read like a well penned Suspense Novel. LOL I was sitting here, and kind of had to pee, but could not stop "turning the pages" on this one!

Very happy for the OP regarding the outcome. At the same time happy for all that I could sense the formation of the old lump in the throat.

God Bless Y'all. Have a great day!

JimmyK
« Last Edit: August 03, 2016, 08:16:28 am by JimmyK »
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.

 


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