Triple Therapy and Cirrhosis

[LiverLifer]

Just a quick poll to see how many cirrhotics have done triple therapy and what their experience was?

[frijole]

I have early cirrhosis - compensated - and treated with Victrelis for 48 weeks and I am SVR.  I am not sure my treatment was any worse than most people's, just longer, the 48 weeks being the required treatment for cirrhotics.  Dee was an exception and cleared with 24 weeks.

What have you got to lose?  Unless your cirrhosis is decompensated, there is no good reason not to treat.  Even if you are decompensated, you may treat under the guidance of an experienced hepatologist (a lot depends on the situation).  In rare cases treating makes the cirrhosis worse but that is rare.  

You have found a good forum (this and the Hepatitis C forum) where you can get lots of good feedback.
frijole

[yodennis]

I am cirrhotic, 1A, and failed both single Interferon (when stage 1) and double Inter/Ribaviron (when stage 2) tx's over the years. This time around (2011-12) with triple tx. my Incivek was abreviated from the standard 12 weeks  to 9-10 weeks because of side effects  (primarily anemia). The remaining Interferon and Ribavirin. was much much easier to tolerate for the rest of the 48 weeks. I became undetectable 3 weeks into therapy and remained undetectable 7 months post tx a.k.a. I cleared it against great odds! d

[ceanothus]

I've had compensated cirrhosis since 2004. I did the triple tx with Incivek, 48 weeks from October 2011 to September 2012. I felt awful through most of tx, but I made it and achieved SVR status as of March 2013.

[Dee1956]

Hi I finished 24 weeks of tx in Feb 2012.  I have cirrhosis and am now SVR
It was a rough tx which my doctor told me it would be but I would do it again to be cleared of the virus.
If you have any questions please ask

[HectorSF]

Viral breakthrough happens in 16% of "hard to treat" patients (advanced liver fibrosis, and prior null treatment response) treating with peg-IFN + RBV + Incivek. This happens after treatment with 3 drugs stops and only Peg-IFN + RBV is being used.
"mean time to breakthrough was 21 weeks"

HCV viral breakthrough is an ongoing possibility during the pegylated interferon/ribavirin continuation phase after triple therapy with telaprevir (Incivek or Incivek or Incivo), especially for difficult-to-treat patients, researchers reported this week at the Digestive Disease Week conference (DDW 2013) in Orlando.

22 May 2013 00:00
Written by Liz Highleyman

"The present analysis included 55 chronic hepatitis C patients who received boceprevir or telaprevir triple therapy at UCLA's Pfleger Liver Institute between June 2011 and July 2012.
Results
• 9 study patients (16%) experienced viral breakthrough while on treatment.
• All these patients were on telaprevir; there were no breakthroughs on boceprevir.
• 8 of the 9 experienced breakthrough during the pegylated interferon/Ribavirin continuation phase after triple therapy.
• *** The mean time to breakthrough was 21 weeks. ***
• 6 patients (67%) who experienced viral breakthrough had harder-to-treat HCV subtype 1a, while 3 (33%) had 1b.
• 6 of the 9 patients (67%) had advanced fibrosis or cirrhosis (stage F3-F4) according to liver biopsies.
• 6 breakthrough patients were prior null responders, 1 was a prior relapser, and 2 were treatment-naive.
• 6 breakthrough patients had ribavirin dose reductions prior to treatment failure, including 2 who also lowered their interferon doses.
• 6 of the 8 breakthrough patients who underwent resistance testing had telaprevir resistance mutations, all of whom also had cross-resistance to boceprevir.
• The 6 individuals with resistance all had subtype 1a, while the remaining 2 had 1b.

"Similar to findings in clinical trials, viral breakthrough with DAA for treatment of chronic HCV infection is associated with genotype 1a, advanced liver fibrosis, and prior null treatment response," the researchers concluded."

Hector

[Advocate1955]

My hubby has Cirrhosis and did triple tx w Incivek, but failed due to a viral breakthrough around week 24.
Advocate1955

[LiverLifer]

Awful grammar - "what their experiences were" is what I had intended to type!