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About to start Zepatier (Elbasvir/Grazoprevir)

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1bit:
Hi everyone

Long-time since I was last here, I started my second bout in 2016 (Abbvie3D + Riba) but had to terminate after just 4 days due to severe side effects. before that I was a responder/relapser on Inf+Riba in 2008/09.

Iam now starting Zepatier (Elbasvir/Grazoprevir) on Monday coming and wanted to know if any other members have had this treatment and what I should expect with regards to sides, I found the Abbvie3D+Riba regime way more nasty than Inf+Riba but thats just my personal experience.. I suffer with extreme Anxiety & Depression and my health isnt the best, Im both excited and scared at the same time (sides)

any advice is appreciated

thanks

Lynn K:
That ribavirin is tough stuff I took ribavirin during two of my three treatments with interferon. I was a null responder my viral load did not decrease even a tiny bit on those treatments.

I was looking at the prescribing information for Zepatier

https://www.merck.com/product/usa/pi_circulars/z/zepatier/zepatier_pi.pdf

Were you tested for the presence of virus with NS5A resistance-associated polymorphisms?

Several previous scenarios look like they recommend taking Zepatier along with ribavirin. You might want to look the information over.

Wondering why your doctor isn’t going with Mavyret as there is no treatment regimen with ribavirin

https://www.rxabbvie.com/pdf/mavyret_pi.pdf

Or Epclusa which only calls for ribavirin for those with advanced liver disease

https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208341s000lbl.pdf

We have had a couple of people retreat after relapse with one of the new DAA’s they treated with either Mavyret or Epclusa and had great results. I don’t recall anyone retreating with Zepatier. I’m also wondering if with your history maybe you should be taking ribavirin along with Zepatier. I’m thinking ribavirin would be the deal breaker for me.

Anyway just my thoughts as a fellow patient maybe read up and ask your doctor if Epclusa or Mavyret might be better for you.

The PDFs also have clinical trial data and common side effect profiles

Anyway best of luck to you
Lynn

1bit:
TBH Im not happy with my specialist because he ALWAYS puts me on cheaper regimens, always 1 or so generations behind what other GP's are giving out, I am dealing with an outreach nurse at the moment and only met her for the first time the other day and she said I would be given either Harvoni or this, I knew straight away that they would give me this because its probably cheaper, and I was right.

She told me that Genotype (1a) doesn't matter anymore?  yet I read the same as you on the basic leaflet that it should be given with Ribavirin for G1 or G4? 

last time I saw the specialist in April he had a remark "you only get 1 bite of the pie, doesnt matter if you were on treatment 4 days or 4 months".. as he was miffed because I missed an appointment in 2016, I called to cancel due to being too poorly from my 2nd bout on Abbvie3D+Riba to travel and was terminating the treatment due to severe sides, the nurse never told him i called and cancelled so he thinks I DNA'd outright (Did Not Attend), Ive had about 20 appointments with him over 10 years and never missed one but that one, this was in April.. I never heard from him again so I kept trying to call but he was always on leave or on holiday or not available, I had to get my GP to write a letter to see what was going on but I managed to see the outreach nurse, she said he already done the MDT paperwork and had me down as ready to start but failed to inform me to get it started, so she initiated it???
... I think he has an attitude problem, I would get a different specialist but if I do that I worry that the new one will be defensive for his colleague and treat me the same...or I may be refused.

and as far as I know I havent been tested for that thing you say but she did say try not too miss any as you can build up a resistance?

Im not having Ribavirin with this...sorry your post confuses me a little.

1bit:
....(continued)

ive just read this on the zepatier PDF:

Hepatitis B virus (HBV) reactivation has been reported, in some cases resulting in fulminant hepatitis, hepatic failure, and death.

I dont have Hep-B but I used to have it?  is this a concern?  re-activation whats that...causes death??

Lynn K:
Here is an article about hepatitis B reactivation 

https://www.hhs.gov/hepatitis/blog/2017/1/17/hbv-reactivation-during-hcv-treatment.html

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