Harvoni + Ribavirin works for previous failed treatment patents?

[RailroadMan]

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?

[JimmyMose]

My non medical opinion is Harvoni 24 weeks as mentioned has quite a bit of data and medical opinion to support very strong recommendation.  Harvoni plus RBV 12 weeks so far has less data and less number of medical opinions.   But as of now appears to have similar results as Harvoni 24 weeks to merit a decent recommendation. Hopefully in the future it will become 1A

My personal comment mentioning "paid trial" was a bad attempt at humor.  No, I do not think you are being used as a human "lab rat"

My heart and thanks do go out to all that have been in trials, especially the ones that failed and or suffered serious long lasting side effects or died over the many years.   Without them none of us would have chance at treatment whether these new ones or in earlier years the less effective and more harmful ones.

Harvoni and RBV are off-label.   Sovaldi or Viekira Pak with RBV are FDA approved and on label depending on GT and condition. RBV  label hasn't been updated for them as far as I know.

Best wishes I believe you have a very high chance of SVR

[JimmyMose]

Sometimes hate typing on smartphone. Plus MH doesn't have a preview before posting.

. Accessed February 12, 2015 is not part of the link

[JimmyMose]

If you haven't already done so I recommend that anyone interested in hcvguidlines go to the home page and then read.  How to cite link. Then Full report. Introduction, methods before going to the recommendations pages.

AASLD/IDSA/IAS–USA. Recommendations for testing, managing, and treating hepatitis C.
http://www.hcvguidelines.org. Accessed February 12, 2015

[JimmyMose]

When I quote a copyrighted source I try to limit it to basic info (fair use).  I use excerpt and suggest if anyone has further interest to go the the link for the details.  Please read first .  For example There is a link on that page that will take you Methods Table 2 that explains Classification and Level.

Now after reading the details someone may be in a better possition to disscuss it.

[RailroadMan]

Harvoni 24 weeks   Rating: Class I, Level A
Harvoni plus RBV 12 weeks Rating: Class IIa, Level B

What does Class 1, Level A mean compared to Class IIa, Level B?

I'm gathering the Riba, being "off label" treatment, is sort of experimental, as the label does not approve it for use with anything except Interferon?

If that's the case, I don't appreciate being a "lab rat" for Kaiser.  At my age time is running out to cure this and avoid liver cancer.  I"m already being banded over and over for vericies, every 12 weeks.

I've the "showdown" meeting with the HEPC team tomorrow.  They tested for PCR at 4 weeks, so we'll see the results tomorrow.  I'll post the results of the meeting.  If it's not quite undetectable I'm going to push for finishing the two-week supply I have on hand and then test again.  I've a record of being very resistant to drug treatment for whatever comes along, antibiotics take 14-16 days to clear something instead of the protocol 7-10 days.

[AWorriedMom]

Actually he said if you didn't clear or relapsed, it would matter to you no matter what the statistics said. So he is recommending 24 weeks for all of his hard to treat patients on Harvoni and Ribavirin.