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Hep C Discussion Forum -> New Members Area -> New member starting Daklinza/Sovaldi for 12 weeks
Post Info TOPIC: New member starting Daklinza/Sovaldi for 12 weeks
wmlj1960


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RE: New member starting Daklinza/Sovaldi for 12 weeks
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Hi Max.

 I'm glad you'll be starting treatment soon. You have found a valuable source of information and support here that will help you make the best of treatment. Although we don't have many members on your particular protocol, most of the information you will find applies across all HCV genotypes and protocols. If you need definitions for some of the abbreviations you'll be seeing, (like I did) especially in the member signatures, click on the link below. Also if you would like to create your own signature specific to you directions for doing that are also included. Welcome to the forum and make yourself at home. We are glad you found us!! smile

Forum Abbreviations Link and Help with Creating your Signature



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60 yo, geno 1a, Dx 1994 HCV-HIV co-inf, Dx 2013 decompensated cirrhosis
Tx #1 - 24wks Sov+Riba /SOT 7-24-2014/UND@EOT/DETECTED@EOT+16 wks
Tx #2 - 24wks Harvoni /SOT 7-25-2015/UND@EOT,+12,+24,+52 = SVR

Mike

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Max


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Thanks for all the info. I will research other discussions.

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Geno 3a interferon/ribaviron 24 weeks relapse EOT at 4 weeks. ALT 64/AST 43 F3 Starting Sovaldi Daklinza for 12 weeks
Tig


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Hi Max,

Yes, it says approximately 75% reach an RVR or undetected viral load by week 4. Actually that's very good odds IMO. It's becoming better documented now, that many on the new DAA protocols don't reach an undetected level until weeks 6 or 8. Still, we're also witnessing quick response times in others as early as week 2! The incidence of detected viral counts (albeit low) at the end of treatment is increasingly documented and SVR is still achieved at EOT +12. These new drugs have a completely different action and shouldn't be compared to the results of the old Interferon/Riba +\- PI protocols. The good news is it happens, the majority of the time. We used to rely on an RVR back then and if by week 8 or 12 we weren't undetected, they stopped treatment. Some practices aren't even doing a mid treatment VL and wait until EOT+12. I don't agree with that, because I think the week 4 or 6 VL and the EOT are very informative and often provide a great morale boost during a stressful time. Some doctors are willing, many have to be convinced (badgered)!

Iron overload is a well known problem in HCV patients. The liver can't process the iron properly, so elimination/absorption is adversely impacted. We have had several members experience similar issues. Use our search function and look for the discussions we've had on "Ferritin". I'm sure you're already aware to be cautious using any iron supplements, especially while on treatment. Dietary sources, in moderation, with your doctor's advice is the way to go.



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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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Max


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Looking at the study results on the clinical trial link. It is interesting only 3/4 get to RVR. If i am reading it correctly. Any thoughts?

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Geno 3a interferon/ribaviron 24 weeks relapse EOT at 4 weeks. ALT 64/AST 43 F3 Starting Sovaldi Daklinza for 12 weeks
Max


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Thanks so much for the quick and meaningful responses. Also great links. I was on a similar site in 2012 and everyone was very helpful. Does anyone have info on iron overload and Tx response. Thx again

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Geno 3a interferon/ribaviron 24 weeks relapse EOT at 4 weeks. ALT 64/AST 43 F3 Starting Sovaldi Daklinza for 12 weeks
Tig


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I don't want to hijack Max's thread, but here's a couple of articles, one dated but on point for your review. We have several existing threads on cirrhosis that we can continue the discussion if you would like.

http://www.hepatitiscentral.com/hcv/fibrosis/reversible/

http://hepatitiscnewdrugs.blogspot.com/2014/04/impact-of-svr-on-liver-fibrosis-and.html

 



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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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Tig


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Hi Max,

Welcome to the forum! I'm glad you're here and hope to follow your road to success along the way. Lots of caring, knowledgeable people here.

You'll be starting a good protocol, that I'm sure of. As you're aware, GT 3 is a tough one to beat, but Dak/Sov is one of the better options right now. There are some new ones on the horizon that will be effective as well.

I'm including a link at the bottom that will take you to the government clinical trials database explaining the Ally trials on your protocol. The rates of success for non cirrhotics is about 95% and drops to about 70% in cirrhotics. I would trust the biopsy over the Fibrosure, hands down. As an F3, you have advanced fibrosis, but are not cirrhotic. You should have a very good shot at beating it this time.

I look forward to hearing about your upcoming tests and if there is anything we can help you with, don't hesitate to ask. Be sure to check out our search function above, we've got a lot of good info on the site, but you're one of the few that have been prescribed Daklinza here. The evidence of a good performance is on your side though. Good luck!

https://clinicaltrials.gov/ct2/show/study/NCT02032901?sect=Xe0156



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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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xtra


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Max

Cirrhosis impairs the drugs dispersal within the liver. if that is what you mean by doing poorly. There is cellular damage and blood supply problems in a cirrhotic liver that inhibit the drug so the virus can hide in areas the drug can't penetrate

However, you raised another interesting question

I have been researching the difference between fibrosis and cirrhosis.

It has occurred to me that Hep has been incurable so most of the information and studies have been alcoholic cirrhosis and maybe fatty liver. Alcoholic/NAFL cirrhosis is often not diagnosed until decompensated.

According to the CDC, Hep C started being a significant problem after 1965. According to some other information, cirrhosis in Hep C takes approximately 50 years to develop to either Fib 3 or early stage 4. So, there aren't many people who had Hep C prior to the mid=60's. Not many Hep C cases beyond the 50 year mark.

Also, liver transplants can be partial. 1/2 a liver can be transplanted into a severely decompensated cirrhotic and the liver will regenerate, right or wrong? So I wonder if the information about cirrhosis being irreversible is true.

Tig posted a Sticky which in a more indirect way, asked the same question. Although Alcoholic Cirrhosis takes 50 - 60 years to develop in some cases, the alcoholic cirrhotics are generally decompensated by that time.

I would be very interested in whether Hep C cirrhosis improved post treatment. True, there may be residual damage to heart and kidneys that may be irreversible but whether even a decompensated Hep C cirrhotic can improve, I don't know. Does anyone? 



-- Edited by xtra on Tuesday 20th of October 2015 06:15:33 PM



-- Edited by xtra on Tuesday 20th of October 2015 06:16:35 PM



-- Edited by xtra on Tuesday 20th of October 2015 06:18:49 PM

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Max


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I am Geno 3a with F3 Fibrosis. I was on Interferon/Ribaviron for 24 weeks in 2012 and relapsed after EOT. I will be starting treatment in the next couple of weeks. I retain Iron and have done many phlebotomies. I am 63 years old and in good shape BMI less than 30. My biggest question is why do the cirrhotics do so poorly. My ALT/AST has never been higher than 64/43. my platelets are 220. But, Fibrosure blood test came back F4 cirrhotic. So we did a biopsy and it came back F3 Fibrotic. There are stark differences between response rates between F3 and F4. If someone has info on this I would be grateful. I also will do my best to report on side effects and blood work 



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Geno 3a interferon/ribaviron 24 weeks relapse EOT at 4 weeks. ALT 64/AST 43 F3 Starting Sovaldi Daklinza for 12 weeks
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