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Genotype 3 - Sovaldi + Ribravin
I hope you find this email in the best of your health. My mother is suffering from Hep C from last 20 years. Currently, she has liver cirrhosis stage 3.
She went through Pega + Ribravin treatment twice but unfortunately, the first time it relapsed and second time we have to stop her treatment, due to severe anemia.
Two months ago, she started Sovaldi + Ribravin treatment and after one month, the viral load was zero. Due to edema, the doctor advised her to take diuretic medication without informing to get electrolytes checked frequently. She suffered with severe hypernatremia and was hospitalized. As her sodium level restored, she suffered with ascites and then possibly SBP, pneumonia or UTI. The doctors are unsure as they never conducted the TAP/ascetis fluid test.
During the infection, we have seen symptoms of decompensated liver such as hepatic encephalopathy and jaundice (yellow of ice). There were no symptoms of decompensated liver before.
She recovered and according to latest Urine DR, Urine C/S, Blood CP and Blood C/S, there is no more infection.
Last night ( it's been one week, she took the last antibiotic to treat infection), she has developed the fever again.The fever gradually increased over 24 hrs and reached to 102 F. Doctor have suggested to continue taking just sovaldi w/o ribaravin. there are no other symptoms along with the fever. She is urinating properly too.
After fever, doctor advised cipro 500 mg twice a day - this has worked as the temperature has down to 99 F.
Pls help me in understanding why the fever is coming back? Does sovaldi + ribravin causing decompensation of liver? should she continue sovaldi + ribravin treatment?
Thank you all !!
She went through Pega + Ribravin treatment twice but unfortunately, the first time it relapsed and second time we have to stop her treatment, due to severe anemia.
Two months ago, she started Sovaldi + Ribravin treatment and after one month, the viral load was zero. Due to edema, the doctor advised her to take diuretic medication without informing to get electrolytes checked frequently. She suffered with severe hypernatremia and was hospitalized. As her sodium level restored, she suffered with ascites and then possibly SBP, pneumonia or UTI. The doctors are unsure as they never conducted the TAP/ascetis fluid test.
During the infection, we have seen symptoms of decompensated liver such as hepatic encephalopathy and jaundice (yellow of ice). There were no symptoms of decompensated liver before.
She recovered and according to latest Urine DR, Urine C/S, Blood CP and Blood C/S, there is no more infection.
Last night ( it's been one week, she took the last antibiotic to treat infection), she has developed the fever again.The fever gradually increased over 24 hrs and reached to 102 F. Doctor have suggested to continue taking just sovaldi w/o ribaravin. there are no other symptoms along with the fever. She is urinating properly too.
After fever, doctor advised cipro 500 mg twice a day - this has worked as the temperature has down to 99 F.
Pls help me in understanding why the fever is coming back? Does sovaldi + ribravin causing decompensation of liver? should she continue sovaldi + ribravin treatment?
Thank you all !!
Agree. Solvadi is not a stand alone drug.
The fevers: I got them a lot when my Hemoglobin was low. This was prior to treatment. So yeah fevers can be associated with advanced liver disease too. Gatorade may help in a pinch for low electrolytes and dehydration from liver disease when water can't help. I keep some in my pantry just in case.
Chills --then the fever. I'd get a new doc and a second opinion. I'd go to ER and see what's up with the fevers. They may keep her for observation at the very least. Why didn't he just lower the riba dose instead of taking her off of it? It makes me wonder if he checked her out before treatment to see if she is strong enough to do it.
These are powerful drugs and not to be mistaken with an event like taking aspirin.
Solvadi/Riba has a good success rate for GT2 and GT3.
AbbVie is coming out with medicine for all GT's in Jan including GT 3. Check it out.
The fevers: I got them a lot when my Hemoglobin was low. This was prior to treatment. So yeah fevers can be associated with advanced liver disease too. Gatorade may help in a pinch for low electrolytes and dehydration from liver disease when water can't help. I keep some in my pantry just in case.
Chills --then the fever. I'd get a new doc and a second opinion. I'd go to ER and see what's up with the fevers. They may keep her for observation at the very least. Why didn't he just lower the riba dose instead of taking her off of it? It makes me wonder if he checked her out before treatment to see if she is strong enough to do it.
These are powerful drugs and not to be mistaken with an event like taking aspirin.
Solvadi/Riba has a good success rate for GT2 and GT3.
AbbVie is coming out with medicine for all GT's in Jan including GT 3. Check it out.
can-do: Oops, mea culpa! Don't know how I missed the 'without'. (Guess I'm not doing quite as well as I thought I was). : -). Best, Pat
aj: I totally agree with can-do and all the others, Sovaldi should not be taken alone.
Again, I wish you and your Mother the best. Pat
aj: I totally agree with can-do and all the others, Sovaldi should not be taken alone.
Again, I wish you and your Mother the best. Pat
Thanks Pooh and Dee for reading my entire post. Something else from Poohs link.
"Sofosbuvir can be used by people with all stages of liver disease including compensated and decompensated cirrhosis. However, it works better for people with less advanced liver damage. Data on safety and efficacy in decompensated cirrhosis have not yet been published."
"Sofosbuvir can be used by people with all stages of liver disease including compensated and decompensated cirrhosis. However, it works better for people with less advanced liver damage. Data on safety and efficacy in decompensated cirrhosis have not yet been published."
Hepatitis C treatment factsheet: Sofosbuvir (Sovaldi)
"How is sofosbuvir taken?"
"Sofosbuvir is taken as a single pill once daily with food. It is not effective if taken alone and this can lead to drug resistance."
http://www.infohep.org/Hepatitis-C-treatment-factsheet-Sofosbuvir-iSovaldii/page/2845322/
"How is sofosbuvir taken?"
"Sofosbuvir is taken as a single pill once daily with food. It is not effective if taken alone and this can lead to drug resistance."
http://www.infohep.org/Hepatitis-C-treatment-factsheet-Sofosbuvir-iSovaldii/page/2845322/
"As for your mother treating with just Sovaldi without Riba her odds would be very low on curing and not sure why a doctor would even go that route as genotype 3 has become the hardest to treat."
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I totally agree with Can-do-man that treating with just Sovaldi and WITHOUT Riba her odds would be very low on curing.
Ajabbar: I am sorry your mother is having these problems. I do hope that her doctor is a Hepatologist. With her complications and liver stage, she really needs to be under the care of a Hepatologist.
---------------------------------------------------
I totally agree with Can-do-man that treating with just Sovaldi and WITHOUT Riba her odds would be very low on curing.
Ajabbar: I am sorry your mother is having these problems. I do hope that her doctor is a Hepatologist. With her complications and liver stage, she really needs to be under the care of a Hepatologist.
"As for your mother treating with just Sovaldi without Riba her odds would be very low on curing and not sure why a doctor would even go that route as genotype 3 has become the hardest to treat."
"without" being the key word...
"without" being the key word...
I think treating with both Sovadli and Riba is also the way to go. My concern is taking the Riba away. Then the chances of being cured would be really low. Plus staying on Sovadli alone might be of concern in his mothers condition.
Hope your doing well patra...:)
Hope your doing well patra...:)
Hi,can-do AND welcome to the forum, Aj.
C, her Dr probably has A's Mother on Sol/Riba is for the same reason my Dr has me on the same meds - also a genotype 3: he said this is the best tx available right now, and if I (we, anyone) becomes Undetected, then it is helping the liver and buying time until the Daklinza is approved, so Dac can be used with Sovaldi - a very powerful combination for Gt3s. The Sol/Dac does not rqure Riba, which is also a bonus! Also, yes, the chances of success are lower than for other genotypes, BUT there are Gt3s who have cleared on it. Like my Dr said, the chances ARE lower than for other genotype, but if you are one of the ones who achieve SVR, then, for you, the percentage is100%.
A: tell your Mom to hang in there, since she has reached Undetected (UND), she is already receiving benefit from the meds and, if, after completion, she does relapse, her liver has has a good rest from the virus, AND it should not be too long too long before the Daklinza is approved ( FDA has the paperwork somewhere). I also asked my Dr what the Ins Co would do, IF I fail on the Sol/Riba, and he said there should be no problem, once the Dac is approved (Sol already is) and I am F3 (Fibrosis, last step before cirrhosis) AND have failed treatments before. Your Mother certainly meets those same guidelines.
How many weeks is she on the Sol/Riba for? I have 6 days lft of 24 weeks.
I have begun to have energy again - I find that exciting --- but scarey at te same time.
Please tell her, one Gt 3 to another, that it is worth the fight, to hang in there!
I will be praying for her ( I pray daily for ALL heppers and for their (our) cure.
Pat
C, her Dr probably has A's Mother on Sol/Riba is for the same reason my Dr has me on the same meds - also a genotype 3: he said this is the best tx available right now, and if I (we, anyone) becomes Undetected, then it is helping the liver and buying time until the Daklinza is approved, so Dac can be used with Sovaldi - a very powerful combination for Gt3s. The Sol/Dac does not rqure Riba, which is also a bonus! Also, yes, the chances of success are lower than for other genotypes, BUT there are Gt3s who have cleared on it. Like my Dr said, the chances ARE lower than for other genotype, but if you are one of the ones who achieve SVR, then, for you, the percentage is100%.
A: tell your Mom to hang in there, since she has reached Undetected (UND), she is already receiving benefit from the meds and, if, after completion, she does relapse, her liver has has a good rest from the virus, AND it should not be too long too long before the Daklinza is approved ( FDA has the paperwork somewhere). I also asked my Dr what the Ins Co would do, IF I fail on the Sol/Riba, and he said there should be no problem, once the Dac is approved (Sol already is) and I am F3 (Fibrosis, last step before cirrhosis) AND have failed treatments before. Your Mother certainly meets those same guidelines.
How many weeks is she on the Sol/Riba for? I have 6 days lft of 24 weeks.
I have begun to have energy again - I find that exciting --- but scarey at te same time.
Please tell her, one Gt 3 to another, that it is worth the fight, to hang in there!
I will be praying for her ( I pray daily for ALL heppers and for their (our) cure.
Pat
Hi, I found a woman, a nurse who treated with this for 24 weeks.
I thought this might help you as she listed all the side effects and fever was one of many of the side effects.
http://blogs.hepmag.com/lucindakporter/2014/03/know_what_you_are_ge.html
I thought this might help you as she listed all the side effects and fever was one of many of the side effects.
http://blogs.hepmag.com/lucindakporter/2014/03/know_what_you_are_ge.html
Hello, welcome to the forum. Can-do-man has given you excellent advice.
As he said we are not doctors here, just fellow patients trying to help each other.
How much longer does your Mom have before she is finished with the treatment? It is really great that she got to undetectable.
I hope she is being treated by a hepatologist.
I would call to talk to her doctor
Take Care
Dee
As he said we are not doctors here, just fellow patients trying to help each other.
How much longer does your Mom have before she is finished with the treatment? It is really great that she got to undetectable.
I hope she is being treated by a hepatologist.
I would call to talk to her doctor
Take Care
Dee
As we are not doctors here it would be impossible to answer or advice as to your first part of your question. What I will say is that having a fever that high needs to be checked out... Hopefully your mother is being seen by a Hepatologist. As for your mother treating with just Sovaldi without Riba her odds would be very low on curing and not sure why a doctor would even go that route as genotype 3 has become the hardest to treat.
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The FDA approved dual therapy using 400 mg once-daily sofosbuvir plus 1000-1200 mg/day weight-based ribavirin for people with HCV genotypes 2 or 3. Sofosbuvir has no food requirements. Reflecting the recent realization that genotype 3 is harder to treat, duration of therapy is 12 weeks for genotype 2 and 24 weeks for genotype 3.
http://www.hivandhepatitis.com/hcv-treatment/experimental-hcv-drugs/4438-fda-approves-sofosbuvir-sovaldi-for-hepatitis-c-genotypes-1-2-3-and-4
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I would question this with her doctor. Wishing you both the very best and welcome to the forum.
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The FDA approved dual therapy using 400 mg once-daily sofosbuvir plus 1000-1200 mg/day weight-based ribavirin for people with HCV genotypes 2 or 3. Sofosbuvir has no food requirements. Reflecting the recent realization that genotype 3 is harder to treat, duration of therapy is 12 weeks for genotype 2 and 24 weeks for genotype 3.
http://www.hivandhepatitis.com/hcv-treatment/experimental-hcv-drugs/4438-fda-approves-sofosbuvir-sovaldi-for-hepatitis-c-genotypes-1-2-3-and-4
---------------------------
I would question this with her doctor. Wishing you both the very best and welcome to the forum.
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