Sovaldi+Olysio svr 12 after Telaprevir (Incivek)

[48weeks]

I don't see many posts where people who have experienced SVR 12 with Sovaldi+Olysio have had a prior relapse or failed treatment with Telaprevir (Incivek). Does anyone know if there is an NS4/4A Protease Inhibitor resistance issue with this situation?

[48weeks]

I feel the same way as Sue, Hector the majority of posters on this site do. Thanks, Tom

[sue4hula]

Thanks for the information, Hector.  You have such excellent information and knowledge.  Thank you for all you do for the HCV community. Best wishes for a successful treatment!

[HectorSF]

Best to wait if you can.

There is resistance at least for a while after failing the 1st generation of PIs. Those that failed a PI were excluded from the COSMOS trial so no data is available for these patients.
Olysio is less effective in GT 1a vs GT 1b. Only 1a patients failed in the COSMOS trials.
Most importantly those with IL28B TT genotype with F0-F2 liver disease had poor outcomes.
Simeprevir/Sofosbuvir  SVR=67%
Simeprevir/Sofosbuvir + Ribavirin SVR=83%

Ledipasvir + Sovaldi excellent results from the ION 2 study. 80% had HCV 1a. Where many had failed a previous regimen that included a first-generation HCV protease inhibitor -- boceprevir (Victrelis) or telaprevir (Incivek or Incivo) -- plus pegylated interferon/ribavirin..
SVR=94%

Hector

[48weeks]

Thanks, my GI wants me to go on Sovaldi + Olysio, but I failed a lot of treatements in the past including a relapse after 48 weeks of Telaprevir triple therapy. I am also a 1a and I have every negative going for me including IL28b TT.  I am going to insist on waiting for the Sovaldi + Ledipasvir, I'm lucky enough to not have cirrhosis as of now. Best wishes to you for SVR and congrats for sticking with your treatment

[sue4hula]

I had this same question before I treated.  Initially, my Hepatologist wanted me to do the Sovaldi/Olysio combo.  While going though the insurance game, he attended the EASL (European Associafion for the Study of Liver). When he returned, I had been approved for the S/O combo.  He decided that due to my failure to clear on the Boceprevir (Victrelis) triple treatment, that the S/O wasn't the best combo for me.  

I started the Sovaldi/Ribavirin/Interferon treatment 5/16.  I finish this Thursday, 8/7.  I am 1a, early cirrhosis, 2 prior treatments.  I was Undetected at week 4 and my liver and kidney function tests are better than they've been in years.  We shall see what my post treatment tests show!  I am hopeful, but realistic.. :)

This is just my story and the path my doctor and I chose.  I trust him and will keep on the fight!

You're question is a good one and I'm glad you asked. See what others say and talk with your Hepatologist.  If you're not comfortable with him and the information, get a second opinion.  I think the main thing is to be comfortable in whatever treatment path you choose- treat now, later this fall, or wait.  My hope is one day we are all cured!