3 drug combo post transplant

[bamiracle]

Has anyone had the new 3 drug combination with Telaprivir post transplant? My husband was to far advanced to get treatment for hep c geno 1b. We were in the VA system because it was a 100% service connected condition, for 5 yrs. As he was getting sicker and sicker, I self referred to UK Med CNTR,Lexington Ky, which is seperated from  VA by a hallway. We saw transplant in Feb 2011 and he got a liver transplant Aug 2011. VA's been very nice about providing his anti-rejection meds until now. We requested treatment for hepatitis c and they declined. They are  now discussing giving his other meds on a fee basis because we went out of the VA system.
VA doesn't have enough data to show that treatment would benefit him post transplant. Has anyone done this?

[bamiracle]

He never received treatment pretransplant as I said before. He was stage 4 fibrosis and we were in the VA system that was telling us he needed a transplant.  They never tried to list him until we went out of the VA and self referred to another hospital. After his transplant I received paper work for him to go to Vanderbilt for an evaluation to see if he qualified for a liver from the VA.  As you can tell I have issues with the VA. They told me for years he was too far advanced to treat and talked about transplant but did nothing. I'm very experienced in veterans with HCV now. I have lost my father, my brother-in-law and almost my husband to it. I've known many who were treated and few that had a SVR. I hope to see that change. My husband knows the risks.. He chooses to avoid developing fibrosis and encephalopathy. As anyone with HCV who gets a transplant hopes for more time before liver damage begins, thats what we hoped for. In saying the donor had HCV I was just saying I would have wished for a healthier transplant but we accepted a high risk organ which meant the donor had a high risk life style.  We knew he was always going to have HCV again, just not fibrosis this soon. Thanks for your post

[orphanedhawk]

If your husband had hep C prior to his transplant, and didn't clear it with treatment, then the fact that the donor liver had hep C is not why he's having problems.
Transplantation does not stop hepC.

I know of a few people post transplant doing the triple therapy. All had to change from prograf to cyclosporin prior to treatment.

[bamiracle]

I heard from the Pharmacy today. We signed all the paper work to start treatment with teleprivir and the two others. The Hepatologist tried to get it through the VA but couldn't.  VA never treated pretransplant and we went out of VA to get the transplant. The pharmacy was so shocked that VA wouldn't pay for the drugs. The Pharm Co's are providing the meds.. Pretransplant my husband read about it until he was to encephaloptic to concentrate. He is sure he doesn't want to be in that shape again. The donor organ was a high risk organ and after the transplant we found out donor was positive for hcv. Can you believe it! He's developing fibrosis. He's had 3 biopsies. It's confirmed agressive. We pray for a SVR. Thanks for you input. Good Luck to You

[Bill200]

I know of four people doing triple therapy post-transplant.  Three of them I know cleared.  Not sure of the status of the fourth.  The three are doing pretty good, just the usual side-effects.   I know more people than that are actually doing it per my doctor and another doctor at another center.  Just got to be careful with it in several respects.

I'm starting in a couple of weeks. Meds are ready to ship, just getting myself ready for it.  

[SusieS2010]

I know someone who was transplanted in St Louis about 18 months ago. She has treated since transplant with triple therapy (Incivek) and has done quite well. As Hector says there have been no studies yet on after transplant triple therapy. I wish your hubby well.

[HectorSF]

Congratulations on your husband's transplant.

There have been no studies done on treating post transplant patients with the new triple therapy. So there is no data. There is also issues with drug to drug interactions which can be very dangerous for transplant patients.

You need to talk to the transplant center where he had his transplant. They will decide if and when he will treat his hepatitis C. He is newly transplanted. He is still adjusting to his transplant and his antirejection drugs. Unless he is have very rapid fibrosis caused by his hepatitis C they won't treat him until his is commonly at least 2 years post transplant.

Again All medical issues must go through his transplant center. Only they know his current health status and what is happening with his hepatitis C. Treating a patient when they are not well enough to treat could cause organ rejection or failure. Leave it up to the experts to decide.

Standard treatment for post transplant patients if Peg-IFN and RBV the same drug he took before. Generally speaking post transplant patients have a 30% chance of cure.

Newer treatment will be available in future years and perhaps your husband with be treated with them in a few years?

Good luck on your husband recovery post transplant.

Hector