Hepatitis C Support Group
Hepatitis C is a blood-borne viral disease which can cause liver inflammation, fibrosis, cirrhosis and liver cancer. The hepatitis C virus (HCV) is spread by blood-to-blood contact with an infected person's blood. Many people with HCV infection have no symptoms and are unaware of the need to seek treatment. Hepatitis C infects an estimated 150-200 million people worldwide.
http://www.aidsmap.com/Sofosbuvir-works-well-despite-multiple-negative-predictive-factors/page/2848419/
The good news is that Sovaldi works well.
The article also lists these "negative predictive factors" - four or more of these increase the risk of relapse in tx w Sov/inf/rib:
- Viral genotype: HCV genotypes 1 and 4 have been considered harder to treat than genotypes 2 or 3.
- Viral load: high pre-treatment HCV RNA (>800,000 IU/ml) is associated with poorer response.
- Sex: men do not respond as well as women.
- Age: older people do not respond as well as younger people.
- Race/ethnicity: people of African descent (and Hispanic/Latino people in some studies) do not respond as well as Caucasian or Asian people.
Body weight: heavier people, especially those classified as obese (body mass index >30), do not respond as well.
- IL28B status: people who carry the TT or CT genetic variations do not respond as well as those with the favourable CC pattern.
Liver damage: people with advanced fibrosis (stage F3) and especially cirrhosis (F4) do not response as those with absent to moderate fibrosis (F0-F2).
- HIV/HCV co-infection: people with both HIV and HCV do not respond as well as those with HCV alone.
- Prior treatment: People who previously showed modest or minimal response to prior interferon-based therapy (partial and null responders) do not respond as well as previously untreated (treatment-naive) people or those who previously responded but relapsed after finishing treatment.
The analysis included 339 treatment-naive patients with genotype 1 chronic hepatitis C treated with sofosbuvir plus pegylated interferon and ribavirin for 12 weeks, 285 treatment-experienced and treatment-naive patients with genotype 2 treated with sofosbuvir plus ribavirin for 12 weeks, and 247 treatment-naive and treatment-experienced patients with genotype 3 treated with sofosbuvir plus ribavirin for 24 weeks.
The good news is that Sovaldi works well.
The article also lists these "negative predictive factors" - four or more of these increase the risk of relapse in tx w Sov/inf/rib:
- Viral genotype: HCV genotypes 1 and 4 have been considered harder to treat than genotypes 2 or 3.
- Viral load: high pre-treatment HCV RNA (>800,000 IU/ml) is associated with poorer response.
- Sex: men do not respond as well as women.
- Age: older people do not respond as well as younger people.
- Race/ethnicity: people of African descent (and Hispanic/Latino people in some studies) do not respond as well as Caucasian or Asian people.
Body weight: heavier people, especially those classified as obese (body mass index >30), do not respond as well.
- IL28B status: people who carry the TT or CT genetic variations do not respond as well as those with the favourable CC pattern.
Liver damage: people with advanced fibrosis (stage F3) and especially cirrhosis (F4) do not response as those with absent to moderate fibrosis (F0-F2).
- HIV/HCV co-infection: people with both HIV and HCV do not respond as well as those with HCV alone.
- Prior treatment: People who previously showed modest or minimal response to prior interferon-based therapy (partial and null responders) do not respond as well as previously untreated (treatment-naive) people or those who previously responded but relapsed after finishing treatment.
The analysis included 339 treatment-naive patients with genotype 1 chronic hepatitis C treated with sofosbuvir plus pegylated interferon and ribavirin for 12 weeks, 285 treatment-experienced and treatment-naive patients with genotype 2 treated with sofosbuvir plus ribavirin for 12 weeks, and 247 treatment-naive and treatment-experienced patients with genotype 3 treated with sofosbuvir plus ribavirin for 24 weeks.
Age; VL over a mil; IL28B = CT; and previously failed or relapsed.
Hey, it's interesting that NOT listed is length of time after being treated.
Oh, I'm Geno 1B which would bring me to FIVE, while you ALL don 't know your IL28B so... four, five, whatever... we're kinda high risk. I GUESS.
In a multivariate regression analysis of the combined data set, only six factors were independently associated with relapse: high baseline viral load (OR 4.7), cirrhosis (OR 4.0), IL28B non-CC (OR 3.4), weight over 75kg (OR 2.5), prior treatment (OR 2.3) and male sex (OR 2.3).The effects of black race, Hispanic ethnicity and elevated baseline ALT were not statistically significant.
SVR12 rates were 100% for people with zero or one negative predictive factor, above 99% for those with two factors and 94% for those with three factors. After this, efficacy dropped off, falling to 88% for those with four negative factors, 68% for those with five factors and 57% for those with six factors.
(personally myself I have 3 factors, cirrhosis, prior treatment, and male sex. I don't know about the IL28b)
If I'm reading the article wrong someone please correct me but that's how I'm reading it.
#Marilyn. S&O is totally different in the way it attacks the virus so the factors to consider are different than in the scenario outlined for Sol/IFN/riba.