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Suggest Treatment For Hepatitis C Genotype 1A

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Posted on Thu, 18 Sep 2014
Question: I have had Hepatitis C Genotype 1A for 30 years. I am treatment naive, have a viral load of 6.8 L, and in the past 6 months have lost about 20 pounds without trying. The infectious disease specialist I am working with in Saginaw Michigan told me that 80% of my liver has cirrhosis. My liver is not enlarged (spleen slightly), I have no excess fatigue, fluid retention or edema, no jaundice, no nausea, appetite is very good, etc. He is suggesting a regime of Interferon, Ribavariin, and the new Sofusbuvir.

I want to go to the Mayo Clinic in XXXXXXX within the next week to get a 2nd opinion. It seems to me that time is of the essence. Currently I am still waiting for BCBS to authorize the Sovaldi. Is a trip to Minnesota which may delay the beginning of treatment by a week to ten days a bad idea. I was once diagnosed with hypertrophic cardiomyopathy by a Saginaw Cardiologist and I went to Mayo for a 2nd opinion. He told me that since, at the time, I was very athletic and worked out a lot that I had nothing to worry about because the Doctor in Saginaw had mistaken the disease for what was actually an athletic heart according to Mayo.

Also, I am an XXXXXXX citizen but also an Irish Citizen. I am aware that Sofusbuvir and Daclatasvir have been approved for this combination (not yet approved by the US) in all the EU countries with a 98% success rate, virtually no side effects, and the government foots the XXXXXXX for all medications for Citizens with Hep C. Do You have any knowledge of this combination of drugs and their effectiveness in Hepatitis C patients similar to me? Thank You.
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Answered by Dr. Dr. Muhammad Sareer Khalil (2 hours later)
Brief Answer:
treatment options explained

Detailed Answer:
Hello and welcome

i really appreciate your concerns.


Genotype 1 A treatment options include

A) SOFOSBUVIR +RIBAVIRIN+INTERFERON
B)SOFOSBUVIR+RIBAVIRIN (if interferon intolerant)
c) simeprivir can be used instead of sofosbuvir but not in cirrhotic patients. So your combination is fine.



the SVR i.e sustained virological response to treatment depends on the Fibrosis stage

90% if f0 to f2
50 to 70 % if greater fibrosis than f2.

Treatment naive patients i.e those who havent got treatment previously, have a better success rate compared with treatment experienced.


let me know if you have any query
thanks.
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Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2906 Questions

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Suggest Treatment For Hepatitis C Genotype 1A

Brief Answer: treatment options explained Detailed Answer: Hello and welcome i really appreciate your concerns. Genotype 1 A treatment options include A) SOFOSBUVIR +RIBAVIRIN+INTERFERON B)SOFOSBUVIR+RIBAVIRIN (if interferon intolerant) c) simeprivir can be used instead of sofosbuvir but not in cirrhotic patients. So your combination is fine. the SVR i.e sustained virological response to treatment depends on the Fibrosis stage 90% if f0 to f2 50 to 70 % if greater fibrosis than f2. Treatment naive patients i.e those who havent got treatment previously, have a better success rate compared with treatment experienced. let me know if you have any query thanks.