Tuesday, 01 August 2017 17:33

    Relapses and Retreatment After DAA Treatment for Hep C.. Featured

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    This article is one of a series I am writing on relapsing and retreatment.
    One of the issues that keeps coming up in today's Hepatitis C world is the issue of relapsing after treatment with the new DAAs, whether Sofosbuvir based treatment or other drug combinations like the VPak or Zep.
    Whilst we know that the manufacturers of DAAs like Harvoni only promise a cure rate of about 95% the exact factors that are responsible for a person relapsing after completion of treatment are not known.
    Certainly a very, very few people appear to carry a mutant variety of the virus that has some immunity to drugs like Sofosbuvir however this is not enough of an explanation.
    Certainly relapsing is one of the most heart breaking things for a person who has completed treatment, particularly as most people have had a " virus undetected" test result before they relapse.
    One of the main causes of relapse, as the two emails below indicate, is not doing a long enough treatment time.
    I don't often get letters from people who have relapsed but on this day I got two. For that reason I am writing this.
    First email:
    " Hi, i am ##f### from Texas... i relapsed one month after completing 8 week of harvoni after it was first released.... when do you think the generic form of VOSEVI will be available?"
    "HI Greg Jefferys
    My husband, has taken Harvoni previously. At that time, due to his viral load, he should have received 12 weeks of Harvoni, however, his insurance company cancelled his rx at 8 weeks. Literature shows he should now take Harvoni for 24 weeks. The last time checked it was 24 weeks for a Harvoni retake. I will verify this information before ordering. I am waiting for a copy of his latest viral load lab results which was taken in November. The lab will take up to 14 days to get me these results, so it won't be today that i order from you."
    So this issue about length of treatment time is an important one.
    The reason that national health services and Health insurance companies push people onto 8 weeks treatment is a matter of simply costs. It is cheaper to treat 100 people for 8 weeks and have 8 patients relapse than to treat 100 people for 12 weeks and have 5 relapse.
    Its an economic model created by the bean counters and economic rationalists who care more about money than peoples' suffering.
    To put this into a perspective I do know a number of people who have failed 8 or 12 weeks treatment and then gone on to do 24 weeks treatment and cleared the Hep C virus.
    So longer treatment, whilst not a guarentee of preventing relapse, is certainly an important consideration and absolutely increases the chance of a cure, perhaps only by a couple of percentage points but it might be those couple of percent save you from relapsing. If you have Health Insurance or if you can get treatment through your national health service and they suggest doing 8 weeks treatment you should seriously consider doing 12 weeks treatment and add the extra four weeks using generics meds. The extra four weeks is not a large expense for most people and will reduce the risk of relapse considerably.
    In the rest of this series I will deal with other possible causes for people relapsing after treatment and also what the retreatment options are
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