hepc the virus that wont go away

[bobbi144]

i have hepc i had a liver transplant i did a yr of hepc treatment and it came back i am in stage 4 liver disease again.how long can i stay in the stage 4 without requiring a new transplant.my numbers are good right now and feeling good.i am 5yrs out on the first transplant

[bobbi144]

thank you will for the information i had never heard of the daclatsvir before..i will strongly urge my dr after transplant to start me on it right away.by the time i get my second transplant hopfully they wont be in study anymore and available for everyone..i havr been on cyclosporine before i heard it works better with the hepc drugs then prograf.im thankful to you will you are a wealth of information.im trying to find out as much as i can.as you know we have to be in charge of ourselves.and our health care thanks again bobbi

[stormy456]

What would we do without you, Will?  You're such a wealth of information.

[willbb]

http://hepatitiscnewdrugs.blogspot.ca/Abstract

Recurrent hepatitis C virus infection following liver transplantation can lead to accelerated allograft injury and fibrosis. The aim of this study is to report the first ever use of daclatasvir (BMS-790052), a potent orally administered NS5A replication complex inhibitor, in combination with peginterferonα and ribavirin in a liver transplant recipient. A 49 year old female developed severe recurrent HCV genotype 1b infection 4 months after transplant with severe cholestasis on biopsy and an HCV RNA of 10,000,000 IU/ml, alk phos of 1525 IU/ml, and total bilirubin of 8.4 mg/dl. Despite partial virological suppression with peginterferonα and ribavirin, progressive allograft failure ensued culminating in retransplantation at 9 months. At 3 months after the second transplant, daclatasvir 20 mg per day, peginterferona2a 180 ug/ week and ribavirin 800 mg/ day were prescribed for early recurrent cholestatic HCV. Serum HCV RNA became undetectable at week 3 of treatment and remained undetectable during 24 weeks of triple therapy as well as during post-treatment follow-up. Daclatasvir was well-tolerated and the trough drug levels were within the targeted range throughout treatment. The cyclosporine trough levels were also stable during and after therapy.

Conclusion: The lack of anticipated drug-drug interactions between daclatasvir and the calcineurin inhibitors coupled with its potent antiviral efficacy make this agent in combination with peginterferon and ribavirin an attractive antiviral regimen worthy of further study in liver transplant recipients with recurrent HCV. © 2012 American Association for the Study of Liver Diseases

Best to you...
Will

[bobbi144]

i am a geno type 1 i checked into the new hepc drugs and if cirrohsis has already set in its non effective and very dangerous so they said i just have to wait for another transplant.i checked the studies they did on people with cirrhosis and some have even died..i wish the new drug had come out before i hit stage 4 thanx for answering bobbi

[orphanedhawk]

Although as far as I know, can-do is right about the new triple tx being off label, I know of several people post transplant that are doing them, some quite successfully.
Best of luck~

[can-do-man]

Good luck to you, as suggested you should talk with your transplant center, the treatment of post transplant patients with the new DAAs is still off-label...

[pooh55811]

I cannot answer your question about how long you will stay at Stage 4 without requiring a new transplant.  

However, the new triple med treatment (Interferon, Ribavirin, and a protease inhibitor) is having good results. If you are Genotype 1 and if you have not already done the triple med treatment, that would be something to definitely consider. If you treat, you would definitely need to be under the supervision of a Hepatologist who is affiliated with a transplant center. Talk with your Hepatologist and see if you are stable enough to begin treatment.

[orphanedhawk]

What has your hepatologist told you ?
Are you genotype 1 ?
If so, I'd think you should do the new triple therapy asap.
Being post transplant the virus is more aggressive, as you know, going to stage 4 in only 5 years.
Nobody has a crystal ball that predicts the future and we are not doctors here, merely people affected by hep C.