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Author Topic: Latest Research On Long Term Sustainability Of SVR  (Read 744 times)

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Offline danton

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Latest Research On Long Term Sustainability Of SVR
« on: November 16, 2018, 01:43:03 pm »
This research was compiled over the last 3 yrs. and was released at the AASLD conference held last week.

Thought I would copy it for anyone interested in having a look as there was a fairly significant interest back when a member here (slats) was discussing his possible relapse.

What seems to be relative in the research (at least to me) is that the long term sustainability of SVR is very prevalent.

This was a very large follow up done on 6600 patients and went for 3 years.

Out of all that it seems only 8(less than .1%) of 6600 patients relapsed past the 12 wk SVR point and 7 of those had done a regime that today would be considered  Not Adequate.(4 did just SOF/Riba alone and  3 did a trial consiting of Vedroprevir and Tegobuvir(which never did make it to market)

No one who did Harvoni out of 1350 patients followed for the full 3 yrs .relapsed.

One poor soul who did SOF/VEL relapsed at week 32 Post tx.

So bottom line... 1 late relapse of 6600 that did a recommended regime.

Also at bottom of page on study there is follow up(again for the 3 years) on HCC incidence after treatment and it would certainly seem that this also is extremely rare.

Something maybe to refer to when we read about how somebody is sure the DAA they took caused them HCC.

All the Best. 

http://www.natap.org/2018/AASLD/AASLD_34.htm


Offline lporterrn

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  • LucindaPorterRN
    • LucindaPorterRN
Re: Latest Research On Long Term Sustainability Of SVR
« Reply #1 on: November 16, 2018, 02:15:08 pm »
Thanks for posting this, especially since many of us are interested in this since it may have occurred to Slats.
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
http://blogs.hepmag.com/lucindakporter/

Offline dragonslayer

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Re: Latest Research On Long Term Sustainability Of SVR
« Reply #2 on: November 16, 2018, 09:16:21 pm »
Thanks, Danton, for finding and posting that study.
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 I fightis thetitis

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Re: Latest Research On Long Term Sustainability Of SVR
« Reply #3 on: November 17, 2018, 03:41:40 am »
This is good news in all categories.
One aspect of the report I'm unclear on, was this from Gilead or completely independent?

The big concern for many was the possible increase in HCC, both reoccurrence and new cases based on previous european studies.
Not that Harvoni or DAA's caused it mind you, rather the possible vulnerable state of the liver's immune cells to fight off cancerous cells due to rapid hcv eradication.

Great job Danton.

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 slats1056

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  • SVR to all and to all a good life!
Re: Latest Research On Long Term Sustainability Of SVR
« Reply #4 on: November 17, 2018, 11:57:22 am »
 Danton,
    Thanx for the link , I will read it in a little bit. Been out of pocket lately due to life in general. I'll be catching up this week as I have some time off for a little R&R. Looks interesting to say the least. Mavyret Tx. is going surprisingly well so far , keeping My fingers crossed. Thanx again for the link!
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 slats1056

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  • SVR to all and to all a good life!
Re: Latest Research On Long Term Sustainability Of SVR
« Reply #5 on: November 17, 2018, 12:24:23 pm »
 Hey Guys,

   Am I reading this wrong or am I missing something ? Great link for sure. I am missing a co-relation to relapse/reinfection to GT1B. Not sure if I am reading this correctly or not.
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 lporterrn

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Re: Latest Research On Long Term Sustainability Of SVR
« Reply #6 on: November 17, 2018, 01:49:42 pm »
Hi Slats,
I'm not sure about your question, but basically this looks like risk of relapse post-SVR is really, really low (around 0.1%). Genotype 1B isn't linked to an increased risk. Cirrhosis is.
In short, you are one in 1000. But I think you are one in a million.
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
http://blogs.hepmag.com/lucindakporter/

Offline slats1056

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  • SVR to all and to all a good life!
Re: Latest Research On Long Term Sustainability Of SVR
« Reply #7 on: November 18, 2018, 10:29:18 am »
 Hi there Lucinda,

     I was just not seeing any reference to GT1B as I was reading . But , I'll be damned is I am not one unlucky S.O.B. ! At least I didn't have to suffer through Interferon/Ribavarin Tx. ! ::) Mavyret seems to be treating Me pretty well. Four weeks down - twelve more to go! :)

    Not trying to hijack Your thread Danton , but I don't recall if I posted the link to this research.
   www.natap.org/hcv.htm  #7  Summary from EASL 2018 for HCV in 2018 as well as several others , too many to list here.
  Looks as though info. is slowly beginning to get published since the Meds are so new. I am not seeing much info. as far as GT1B relapse after Harvoni Tx. as of yet. Just curiosity on My part I guess. :-\ As Danton & I discussed on an earlier post , that is basically a moot point in relation to the current Treatment/Re-treatment protocols in place. All in all , We are living in exciting times as far as Medical advances in regards to HCV research , meds. , and treatment.

                                          Tommy

 THE BIGGEST LIE I TELL MYSELF IS "I DON'T NEED TO WRITE THIS DOWN , I'LL REMEMBER IT!"
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 Mugwump

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  • My number of posts means nothing, piscor ergo sum!
Re: Latest Research On Long Term Sustainability Of SVR
« Reply #8 on: November 18, 2018, 03:50:42 pm »
Slats; being an anomaly is a royal pita, especially if you are one! This is why my suspicion leads me to think that something reduced the level of the drug you received. Assuming that the meds were kosher as you received them, then the only other part of the equation I can think of; is the fact that one of the components of Harvoni is absorbed differently. Your system might very well not have metabolized the drug completely for the full twelve weeks.

Seems to me that you had a bit of a rough ride with Harvoni, could be that you were also fighting off something that messed with your system at the same time.

The clinical trials of Harvoni did not say anything about catching other diseases while on Harvoni. It would be unreasonable to assume that the flu or other crud disease might not effect how a drug like Harvoni works in unexpected ways.
Caution shameless self promotion below :-)
https://www.hepmag.com/article/eric-reesor-27742-782589663
DING DONG MY DRAGON (HCV) IS FINALLY DEAD!

Offline slats1056

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  • SVR to all and to all a good life!
Re: Latest Research On Long Term Sustainability Of SVR
« Reply #9 on: November 18, 2018, 11:34:08 pm »
 Hey Fellow HCV Warriors,
     In reference to the link I gave earlier , #40 is also very informative!

   Mugwump,
     Was I supposed to be the anomaly or the pita? ROTFL I am wondering about the Ledipasvir part of the equation! I'm getting severe brain fry trying to research possibilities in the grand scheme of the puzzle. So many variables it is mind boggling!
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 danton

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  • Posts: 30
Re: Latest Research On Long Term Sustainability Of SVR
« Reply #10 on: November 20, 2018, 01:30:36 pm »
 I fightis thetitis:

Hi Greg,
You asked,

"One aspect of the report I'm unclear on, was this from Gilead or completely independent?"

Good question ,that particular follow up was done by Gilead in what's called a "Registry follow-up" from a large number of their studies. Asking the institutions that ran their trials to keep follow-up data,send to them, then they compile the data and disseminate.

So I guess the next question that is on our minds,are they giving us the straight goods or fudging the numbers.

That is something that I guess we will never know for absolute certain,however there are some independant follow ups going on that are Real-world data that I have linked below (as it seems to pertain to the HCC question ) amongst all kinds of other info. if you or anyone is interested in sifting thru it)

This link was data compiled By Prof. Jordan Feld(a world-renowned Hepatologist in Hep C just recently for the Conference.

http://www.natap.org/2018/AASLD/AASLD_151.htm


Hi slats:

Glad to see you are well on your way with treatment and just read with no side effects.

Wishing you success and I have copied this for you (also from Felds compilation),the newest info. on Mavyret. The take away on this is that of all the 34  1b's that relapsed then did Mavyret  (and some for only 12 weeks) ALL SVR'd . So 100%.

You know slats, it would seem (to me anyway),like we had discussed before, your doctor saying it was moot on whether you were re-infected or relapsed is the best way of looking at it. The treatment would be the same anyway and with such great success with this drug ,I imagine he/she has lots of confidence in your success this time.

Good luck!   Here is that image from Dr. Felds compilation


http://www.natap.org/2018/images%20/111918/111918-9/11191816.gif

Offline slats1056

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  • SVR to all and to all a good life!
Re: Latest Research On Long Term Sustainability Of SVR
« Reply #11 on: November 21, 2018, 11:17:19 am »
   http://www.natap.org/hcv.htm

  Man this link is full of just about everything pertaining to anything related to whatever You are looking for about Tx. regardless of Meds. , condition , Genotype , sub Genotype , etc. etc. ! You name it , it is probably in there. This is the most current/up to date release of info. on just about all aspects of HCV that I have run across. I am supposed to be on vacation but, I have spent a lot of My spare time going through this link over the last couple of days! Just keep going back and reading info. pertaining to My self , yet seeing so much more about everything else. Kinda like the Eveready bunny , it just keeps going and going and going! As I seem to be the first GT1B relapser/re-infected on Harvoni Tx. My Doc has treated , once I self advocated My case and brought them up to speed as far as 16 weeks Tx. needed (and pointed out their handout leaflet and Abbvie brochures were out of date , all has gone so smooth that I am shocked. I just received a rather large envelope from Abbvie about release of info. on My case as far as Labs. and Medical history that I am checked out.

                            Onward through the frogs people!

                                                   Tommy ( Slats )

 AT THE END OF THE DAY---LIFE SHOULD ASK US "ARE YOU SURE YOU WANT TO SAVE THE CHANGES?"


  Hi Danton,

    Thanx for the well wishes! Per the Moot point thing , I am past it thank God! Still curious but not worried or obsessed ! LOL!  I am still worried about test results for My kids as any parent can tell You! My ex came back negative , one kid still has to schedule test and one is in the pipeline. THAT is My biggest worry in all of this. I need this to be done for My peace of mind regardless of the relapse/re-infection paradox.

                    Have a Great Holiday Everyone!
                                Tommy
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

 


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