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Author Topic: resume ledifos after a while  (Read 4578 times)

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Offline marian

  • Member
  • Posts: 3
resume ledifos after a while
« on: May 12, 2017, 02:12:20 pm »
Hi,
I took Ledifos for 12 weeks but I didn't manage to get rid of the virus. Shall I resume the treatment after a while, but for a longer period, say 24 months? The virus load is about 135000. Does it make sense to try again or the cause is completely lost with ladifos because the virus get resistance to Ledifos?

Offline gnatcatcher

  • Member
  • Posts: 1,372
Re: resume ledifos after a while
« Reply #1 on: May 12, 2017, 05:30:22 pm »
Hi, Marian.

I did a search on "ledifos" and see that it is the generic version of Harvoni in India and that, like Harvoni, it is to be taken strictly under medical supervision. Your doctor is the best person to guide you as to what to do next, but the following may be helpful.

The test that showed that your VL is still around 135,000 -- was that test taken at the end of treatment? If so, some people who still have a viral load at the end of treatment go on to clear the virus. The test that is taken twelve weeks after the end of treatment is the important one: if undetected then, you are considered cured.

If you are still detected twelve weeks after the end of treatment, then your doctor may want to perform resistance testing before deciding what to prescribe next. Hepatitis specialists usually follow the IDSA AASLD Guidelines, which are updated whenever new medicines get approved or new scientific studies change best practices. Here is the link: http://www.hcvguidelines.org/full-report/retreatment-persons-whom-prior-therapy-has-failed

Best wishes,

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 marian

  • Member
  • Posts: 3
Re: resume ledifos after a while
« Reply #2 on: May 13, 2017, 04:07:29 am »
Thanks a lot for the quick and documented reply. The question now is to find a physician able to check whether or not the virus is resistant to the treatment.
Marian

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,461
  • Get tested, get treated, get cured, fight Hep c!
Re: resume ledifos after a while
« Reply #3 on: May 14, 2017, 06:13:10 pm »
Some patients were retreated successfully with Epclusa not sure if that is available overseas yet or what the name is.

I failed 12 weeks of Sovaldi and Olysio and retreated with Harvoni for 24 weeks plus we added ribavirin a few weeks after I started so my overall treatment was 24 weeks Harvoni and 15 weeks of ribavirin.

Were you not under the care of a physician while you were on treatment who followed your care?
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 marian

  • Member
  • Posts: 3
Re: resume ledifos after a while
« Reply #4 on: May 15, 2017, 01:16:51 am »
Thanks a lot for optimistic solution. I will be supervised by a physician for sure, whom I am looking for now.
Marian

Offline Gaj

  • Member
  • Posts: 172
  • Optimist
Re: resume ledifos after a while
« Reply #5 on: May 15, 2017, 04:10:10 am »
Hi Marian,

Sorry to hear of your relapse. While these new medications give +90% cure for most patients on their first attempt this does still mean that a small group of us do relapse at the end of treatment. Don't be disheartened by this, we may take a little longer but we will succeed! :)

The others have provided excellent advice about seeking expert medical guidance regarding what steps to take next. I'm not sure where you are located or the available medical support so a couple of extra thoughts:

Resistance testing can be a great option that is useful to choose the most suitable medication where there are multiple choices available. But you should remember that it is about improving the odds rather than being a guarantee so if lack of availability or affordability rules testing out do not despair as there are other approaches that can be taken as below.

Retreatment usually calls for "longer", "stronger" or "extra" (pick two of these). An (non-specific) example for someone who has already tried Harvoni may be something like 12 weeks Epclusa + ribavirin (stronger and extra) or 24 weeks Epclusa (stronger and longer). But this will vary by genotype and liver status which is why specialist advice is important.

If you struggle to find a suitable specialist you could try asking here while indicating the general area you are located and someone may be able to make a recommendation.
Male - 61 years
Genotype 3a (since 1978?)
Diagnosed 2012
Treated 2013 PEG/Riba/Dac (Relapsed)
F4 - HCC#1 Resected 06/15 - #2 RFAblated 11/15
11/18/15 Commenced Generic Tx - Sof/Dac/Riba (24wks)
Pre Tx = ALT: 270  AST: 209  ALB: 31
05/05/16 = ALT: 34  AST: 32  ALB: 40  VL: Undetected (EOT)
06/16/16 = Relapsed
06/23/16 = ALT: 92  AST: 59  ALB: 40  VL: 290,770
01/12/17 3rd Tx - Zepatier + Sofosbuvir (16wks)
05/03/17 EOT und
06/22/17 SVR7 und
07/27/17 SVR12 UND!
10/26/17 SVR24 UND & Cured!!!

Offline Gaj

  • Member
  • Posts: 172
  • Optimist
Re: resume ledifos after a while
« Reply #6 on: May 15, 2017, 04:12:24 am »
Quote
Some patients were retreated successfully with Epclusa not sure if that is available overseas yet or what the name is.

Hi Lynn, there are several epclusa generics currently available including Sofovel (Beacon) and Panovir (Incepta).
Male - 61 years
Genotype 3a (since 1978?)
Diagnosed 2012
Treated 2013 PEG/Riba/Dac (Relapsed)
F4 - HCC#1 Resected 06/15 - #2 RFAblated 11/15
11/18/15 Commenced Generic Tx - Sof/Dac/Riba (24wks)
Pre Tx = ALT: 270  AST: 209  ALB: 31
05/05/16 = ALT: 34  AST: 32  ALB: 40  VL: Undetected (EOT)
06/16/16 = Relapsed
06/23/16 = ALT: 92  AST: 59  ALB: 40  VL: 290,770
01/12/17 3rd Tx - Zepatier + Sofosbuvir (16wks)
05/03/17 EOT und
06/22/17 SVR7 und
07/27/17 SVR12 UND!
10/26/17 SVR24 UND & Cured!!!

 


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