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Harvoni + Ribavirin works for previous failed treatment patents?

I have failed treatment for HEPC three times in the past; Interferon, Interferon + Ribavirin, and Interferon+Ribavirin+Tepavier.  I also have compensated cirrhosis.  I've had HEPC for over 50 years. Currently I'm on week 4 of Havoni + Ribavirin (1200 mg a day + 1 Harvoni).  I read that the recommended duration for we hard-to-treat previous non-responders is 24 weeks, but my clinician is insisting 12 weeks will be good enough and there is no difference in the outcomes for 12 weeks vs 24 weeks.  Is this correct data?
34 Responses
Avatar universal
According to professional recommendations as of this date for GT1 you are on one of the two approved treatments using Harvoni for your condition.

AASLD/IDSA/IAS–USA. HCV testing and linkage to care. Recommendations for testing, managing, and treating hepatitis C.

http://www.hcvguidelines.org/full-report/retreatment-persons-whom-prior-therapy-has-failed
Accessed February 10, 2015
Excerpt please read full report for details
Recommended regimens for patients with HCV genotype 1a or 1b infection who have compensated cirrhosis, in whom prior PEG-IFN and RBV treatment has failed.

Harvoni 24 weeks. Rating: Class I, Level A
Harvoni plus weight-based RBV 12 weeks. Rating: Class I, Level B

Reminder to all quoting hcvguidlines please follow
http://www.hcvguidelines.org/news/how-cite-and-permissions
Accessed February 10,  2015
Avatar universal
Some detailed info about Ledipasvir-Sofosbuvir (Harvoni) including clinical trials, references and slide deck at Hepatitis C Online

http://www.hepatitisc.uw.edu/page/treatment/drugs/ledipasvir-sofosbuvir
Avatar universal
Sorry I was multitasking and only provided technical links.

Welcome new member I am sure more will reply soon.  This isn't live chat so check back whebn you can.  Many members here will be glad to offer their non medical opinion for any concerns you may have during or after treatment.

I looked as some of the clinical trials and your trearment has a high chance of sucess in my non medical opinion.   Probably in the mid 90's and statistically close to Harvoni alone for 24 weeks.  It appears that the doctor and the insurance company agree this is the most cost effective treatment available at this time for you.    Retail cost a little under $100k vs under $200k in USA.  Even with big discounts. $50k vs 100k.

Since your on RBV doctors will want to monitor your hemoglobin. Best wishes for completing tx and achiving SVR.
Avatar universal
Thanks for the info.  It seems from all the reading that for difficult-to-treat people with cirrhosis who have had the virus for decades the protocol should be combined Harvoni + Ribivrin for 24 weeks to achieve the highest chance of success.  I'll be arguing that point with the Kaiser clinicians.
Avatar universal
24 weeks for prior non responders is my understanding for Harvoni treatment. It does make a difference. 12 weeks is not long enough for those who have treated before and failed. 12 weeks is for treatment naiive patients only. Added Riba is for other than GT 1a & 1b but they still may give it to 1's for serial treatment failure.
Avatar universal
I think if can be difficult to understand some of the finer details as a non medical person.   I was GT2 with cirrhosis and started SOL/RBV
April 2014 at the 12 weeks was the recommendation but I noticed some research indicating 16 weeks was better.  I asked my doctor and his opinion was 12 weeks and my viral load was just over 800k and had never been over 1.4 M.  I did achive SVR.  Now the guidlines mention 16 weeks for cirrhosis as a consideration for doctors.

Do you know your viral load AST, ALT hgb, platelets before start of tx? I do see mention for GT1 8 weeks tx nieve no cirrhosis under 6 M in the gguidelines.  I haven't found any info for your situation about pre tx vl and have no knowledge whether it does.

Best wishes if you are able to get approval for longer tx but don't be discouraged if you don't.   You still have an excellent chance of achiving SVR.  Please keep us informed about your treatment and blood test if you want.

If you click my name you will go to my personal page.  On the lower left side are my journals for pre tx, tx and post for anyone interested.  Many. blood work and other info is provided.  You can skip over some of my wordy details of my activities.

I recommend members consider posting some basic up to date info about their HCV condition and treatment somewhere on their personal profile page.  This way members can refer to it in future posts without repeating asking for more info or searching prior post.

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