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Post Info TOPIC: I have to decide to treat or not
rebeca


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RE: I have to decide to treat or not
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Thank you, Garfield

I´ve sought information  about SOFOSBUVIR,at the following web and I ´ve read they have  demonstrated Week 12 sustained virologic response (SVR) rates that typically range from approximately 60% (in genotype 3) to > 90% (in genotypes 1, 4, 5, or 6)

 That´s great!

 

Do you know this web? I think it´s very good:

http://www.clinicaloptions.com/inpractice/hepatology/hepatology/ch9_hep_c_management_in_special_populations/pages/page%204/subpage%205/sub%20subpage%201a.aspx

 



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52 yo. Genotype 1a. 1.500.000 VL. Fibroscan : 8 . Probably I infected in 80s. I´ve never been treated. I've started Harvoni, 9/02/2015. 12 weeks. 
garfield


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rebeca wrote:
 When you talk about sofosbuvir, you mean this one alone. or in combination with interferón?

you are lucky to live in Germany. Anyway, I hope the health protocols are made at European level.

Thank you very much

Hi Rebeca,

Sofosbuvir alone isn't possible. The  first approval for Gt1 will be Sofosbuvir/Interferon/Ribavarin.

Perhaps in a year approval for an interferon-free therapy will follow either Sofosbuvir/Ledispavir/Ribavarin or abbvie with the drugs I was  taking.

cheers



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rebeca


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garfield wrote:

Hi Rebeca,

         a spanish study to the chance for svr.

"Variations at multiple genes improve interleukin 28b genotype predictive capacity for response to therapy against hepatitis c genotype 1 or 4 infection" 

Although they were watching hiv/hcv coinfected, you can realize, the chance for svr is a question of your genes.

"Subjects: 205 HIV/HCV genotype 1 or 4-coinfected patients who received a complete course of Peg-IFN/RBV for 48 weeks.

..... In this study, using three genotypes (IL28B/AQP-2/TGF-b), the probability of SVR increased to 80% for the favorable combination and it was only 7% for the triple unfavourable genotype........"

origin:  http://www.natap.org/2013/HCV/073113_05.htm

 

I don't know your spanish health insurance system. For Germany I can say we will have Sofosbuvir immediately after approval, estimated in early spring 2014.

Most hepatologist prescribe therapy not anymore and refer to Sofosbuvir. 

For my part I would never start at the moment with therapy. I should wait if I were you.

 

cheers

     

 Thank you for your advice,

I´m thinking I prefer really to wait. I don´t think dual therapy is for me ( %50) and the triple therapy is too hard (in the case I would treat). When you talk about sofosbuvir, you mean this one alone. or in combination with interferón?

you are lucky to live in Germany. Anyway, I hope the health protocols are made at European level.

Thank you very much



__________________

52 yo. Genotype 1a. 1.500.000 VL. Fibroscan : 8 . Probably I infected in 80s. I´ve never been treated. I've started Harvoni, 9/02/2015. 12 weeks. 
garfield


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Hi Rebeca,

         a spanish study to the chance for svr.

"Variations at multiple genes improve interleukin 28b genotype predictive capacity for response to therapy against hepatitis c genotype 1 or 4 infection" 

Although they were watching hiv/hcv coinfected, you can realize, the chance for svr is a question of your genes.

"Subjects: 205 HIV/HCV genotype 1 or 4-coinfected patients who received a complete course of Peg-IFN/RBV for 48 weeks.

..... In this study, using three genotypes (IL28B/AQP-2/TGF-b), the probability of SVR increased to 80% for the favorable combination and it was only 7% for the triple unfavourable genotype........"

origin:  http://www.natap.org/2013/HCV/073113_05.htm

 

I don't know your spanish health insurance system. For Germany I can say we will have Sofosbuvir immediately after approval, estimated in early spring 2014.

Most hepatologist prescribe therapy not anymore and refer to Sofosbuvir. 

For my part I would never start at the moment with therapy. I should wait if I were you.

 

cheers

     



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mallani


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Hi Rebeca,

You have a difficult decision. In Spain, with the cuts to health expenditure, it may be quite a while before you have access to DAA's. The F4's and F3's will have priority.

Have a read of the following article. With the CC allele and a moderate Viral Load, you have a 69% chance of SVR with Peg/Riba.(for 48 weeks).

http://www.gastrojournal.org/article/S0016-5085%2810%2900574-3/fulltext

If you don't like those odds, you will have to wait and hope that Spain's economy improves.

I agree that Peg. may cause side effects.  However I would rather have Rx as an F2, rather than risk progressing to F3-4.  Good luck.



__________________

Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
Tig


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Nope, I agree with you Trout. Even with the CC IL28B results, the rate of success with Dual therapy is far too low for 1a and the side effects are anything but pleasant. In many instances the side effects can turn into long term health problems.

Rebeca, considering your low VL and your F2 diagnosis, I feel you have time to wait for a better treatment option. If I were going to consider treatment with Interferon again, it would have to include more options than Ribavirin alone. If you do decide to go that route, you'll have to prepare yourself for a 48 week course of treatment. As mentioned before, the rate of success after putting yourself through that grueling course of treatment isn't that impressive. Good luck with your decision.



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Tig

67yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

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TeddyTrout


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I personally would wait if I could. I am just coming off of my very last day of triple therapy of 48 weeks. I was on the duel therapy in 05 and 99 and it totally messed up my life with permanent disabilities and side effects. I swear I would never go back on treatment in 05 unless I had a 70% chance at winning the battle, Well I will have to wait for my pcr to see if I'm SRV or not. Best of luck to you and unless your F3 or 4 I'd wait. I sure many will weight in and say just the opposite and maybe I'm just full of riba rage and should keep my thoughts to my self. Good Luck. F2 is a had point to be at as it makes sense to treat from a health point of view and you have a 48% chance of cure. I'm sorry to hear that these new therapies are not available to you in Spain. I guess the world recession and the extreme monitory problems limit your heath budgets and choices.  



-- Edited by TeddyTrout on Wednesday 16th of October 2013 11:33:35 PM

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rebeca


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Hello everyone,

As you know I live in Spain so, at the moment I can only  access the dual therapy. Next december, I have an appointment with the hepatologist, and I have to decide.

My status:

50 yo. Genotype 1a.VL  800.000. Fibroscan, in June 2013, (7.4.) F2 (in beginning of F2 ). IL28B CC genotype. I have the virus since 1982, I suppose. Detected in 1992. Never treat.

Do you know some web to see the statistics of treatments? I know 1a is the most difficult to treat, isn´t it?

If I decided I do not, I can only wait, maybe the best option in my situation... I don´t know...

But I suppose that if they have a better treatment, in Europe and in Spain, we will get it, perhaps in 2015. Do you think I´m too optimistic?

 

 



-- Edited by rebeca on Wednesday 16th of October 2013 06:14:12 PM

__________________

52 yo. Genotype 1a. 1.500.000 VL. Fibroscan : 8 . Probably I infected in 80s. I´ve never been treated. I've started Harvoni, 9/02/2015. 12 weeks. 
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