Hepatitis C :: Relapse After Daclatasvir And Sofosbuvir Treatment


Mar 23, 2016

I have just found out that my father who has finished his 12 weeks treatment (Sofosbuvir + Daclatasvir) about a month ago has had the virus relapse. It was undetectable in all previous tests, but the recent test showed it. I was wondering if anyone can point me to the right sources, perhaps specialists and experts we could contact as in Poland (where we live) there doesn't seem to be enough information. We are not sure what to do next... He has had this horrible virus for more than 10 years, we were so happy to have cured it! But refuse to lose hope and want to keep fighting!

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Hepatitis C: Post Treatment :: Sofosbuvir+Daclatasvir Treatment Relapse

I'm looking for advice. My 60 year old father (who has had HCV for more than 10 years; previously treated with Interferon but bad side effects) finished his 12 week Sofosbuvir+Daclatasvir (considered same as Harvoni) treatment a month ago. Already first tests after 2 weeks showed virus was Undetected, but yesterday he received his most recent results and he has a relapse of the virus. He is genotype 1, fibroscan result 4 (close to final stage). He is based in Poland and I'm not sure if our doctors are fully informed of the new generation medications and HCV itself.

Is anyone able to give us any advice? We are pretty desperate and my dad is just so depressed as he thought he finally got rid of the virus (he got infected while on an operation in a public hospital) and now it is back...

Are there any specialists that you are aware of I could possibly get in contact with?

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My physician was concerned how my immune system was attacking the liver and between all treatments, in three days the readings are coming down. My jaundice is going and my urine now looking paler (almost normal).

Given the symptoms indicate a severe acute response to infection, does this suggest my body will put up a good fight to rid itself of the virus. Also, is there a risk Viread could actually lead to my body not developing the antibodies? I've read the following study, which suggests Viread can be highly effective in treating severe acute Hep B and also assist (or at least not inhibit) the development of antibodies.

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My sister in law, a very good doctor who has always given me sensible advice when I have asked, suggested I get my CRP checked.  CRP is apparently a marker for inflammation in the body, although lupus and rheumatoid arthritis do not always trigger it.  

I know I sound like a broken record, but I really think a lot of post-interferon syndrome can be explained by body-wide inflammation - chronic fatigue arises from an inflamed brain; psoriasis is inflamed skin; arthritis is inflamed joints; fibromyalgia is inflamed muscle tissue; vasculitis is inflamed blood vessels, etc.

Our immune systems were amped up by the drugs, and they never settled down again quite right.  The drugs induce autoimmune disorders that can effect every system of our body.  

If I eat bagels and cream cheese (I love bagels and cream cheese) for two or three days in a row, and throw in a pizza, all my inflammatory symptoms get worse, including depression and fatigue.   My ankles swell.  My psoriasis gets worse.  My joints start aching worse.  My fingers start trembling and twitching spastically.  I had nothing like this before treatment.

So anyway, if anyone cares to follow this theory, it means eating  a non-inflammatory diet - no pizza, no fast food, skip the sugar, read In Defense of Food.  The more you want to live, the better you will eat.    If anyone cares to follow this theory and is having their blood drawn anyway, be sure and get CRP checked.   My sis-in-law says it's very inexpensive test.  I'd love to hear of any correlation or thoughts on this subject. 

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When I first began treatment with pegasys in january 2014, GGT was 60 (normal max is 35), ASAT 51 (normal max 35), ALAT 76 (normal 10-40), LDH/Bili/CK all within normal range. With pegasys, a few months later down the line, the values continued to go higher. At their highest, GGT 223, ASAT 116, ALAT 156, LDH 274, Bili/CK remained within normal range.

At the beginning of the treatment, Hep B ie/ml  was 2400. Four months later, it became 2600.  When I was shifted to tenofovir/Viread three or months after beginning treatment since pegasys wasn't solving the issue, the ASAT, ALAT, LDH came back down to normal levels quite fast.  So I have been on viread ever since.

10 months after beginning treatment, Hep B ie/ml was down to 1800. In 2015, it was less than 150. Hep B Dna was undetected by May 2015.  I get regular blood tests every three months since the start of the treatment.  

Yesterday's blood test showed:   ASAT 36 (normal max 35), ALAT 38 (normal 40, but having checked past blood tests, it seems in the last few months it has been gaining one or two points steadily so this is worrying me), LDH and Bili are normal. The bad news: Heb B DNA detected...and IE/ml was a whopping 3400!!!! More than when I started started treatment!

The first thing I was asked was whether I missed a dose of viread. Answer is no. However, I have had incidents where I did forget to take it on time, but it has never exceeded 5 hours (still, I know, it's a huge gap). Not a lot of times, but I find that I am beating myself over this now, as it may be the reason I am having a viral overload and maybe made the virus resistant to viread.

Since taking viread, I have experienced and continue to experience extreme muscle pain (I ended up in the hospital once when diclofenac  failed me and I needed an extra morphine shot to get relief). I am continuously tired, some days it is a real struggle to move (feels like going through mud - heavy body, wanting to simply just crash on the floor). I have not had a pain free day in the last two years and worse, kidney stones! I am already prone to them, but I can't get over the suspicion that Viread has ensured I have a stone that needs to be taken out each year.

I've read that viread is one of the best treatment there is (hardly any side effects, probability of virus resistance low) so my latest blood test is worrying me no end. I am not due for another DNA test until 6 months later. I've also read that ASAT and ALAT values can increase and it's not necessarily liver related (I think my ongoing and increasing muscle pain is reflecting higher ASAT and ALAT values but who knows?!?).  

My doctor says that as long as those values remain within normal range and not in the hundreds, it should be ok. But there is this unspoken thought that I am in deep trouble if the DNA continues to manifest and my liver enzyme values continue to increase.  My liver scan in 2014 has me a point JUST before entering cirrhosis stage. I can't help but think I may have actually crossed that line already (the cassandra in me speaking) though I am assured that viread treatment tends to pull back the damage.

My question..Has anyone ever experienced a viral increase during the viread treatment, and if so, was it temporary, or was viread stopped? I am not sure how to read/interpret  this ie/ml, but the fact that it has increased can't be good news at all.

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I have high platelets 534

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Research suggests that 'EN' is associated with a specific version of Sarc, Lofgren syndrome, which is usually resolves quickly and without treatment.

I'm scared to go to the Dr, as I don't want to face the tension & round of tests to exclude a Sarc relapse. It's not something I want to go through again...

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The only other query on my mind is the fact that I was given a Pneumonia jab 3 weeks ago, could this play a part.?

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