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The time has arrived to start treatment. While there has been delays in this of warehousing of patients, I am relieved but slightly nervous. I think this is totally normal for starting treatment, but I feel I have a good understanding of the treatment and I have also engaged in ways to support myself through the next 12 weeks of treatment.
I have built up a good relationship with my nurse and together we have come up with a clear treatment and care plan, which I feel is important taking control of my treatment. It’s important that your care team and you are flexible and you are able to fit your treatment into your life.
I will be taking Viekirax (paritaprevir/ombitasvir/ritonavir) and Exviera (dasabuvir) plus Ribavirin (Copegus)
Viekirax and Exviera are two new medications used to treat hepatitis C. Viekirax is a combination pill containing paritaprevir and ombitasvir with a booster dose of ritonavir. Exviera or dasabuvir is a separate pill usually taken with Viekirax. This regimen offers a new interferon-free option for me.
How does Viekirax and Exviera work?
Viekirax contains two direct-acting antiviral drugs that target different steps of the hepatitis C virus (HCV) lifecycle. Paritaprevir is an HCV protease inhibitor, meaning it blocks the protease enzyme which the virus needs to reproduce. It is combined with a small dose of ritonavir to boost its level in the blood. Ombitasvir is an HCV NS5A replication complex inhibitor that interferes with another important HCV protein. Exviera or dasabuvir is a non-nucleoside HCV polymerase inhibitor that blocks a third viral enzyme. Targeting multiple steps of the HCV lifecycle makes the combination more effective and makes it harder for the virus to develop drug resistance.
Who can use Viekirax and Exviera?
Viekirax and Exviera are indicated for use by adults with chronic hepatitis C, meaning infection lasting more than six months. Viekirax plus Exviera, taken with or without ribavirin, were approved for people with HCV genotype 1. Genotype 1 is the most common type in Europe.
Viekirax and Exviera can be used by people being treated for hepatitis C for the first time (known as ‘treatment-naive’) and for retreatment of people who were not cured with previous interferon-based therapy (known as ‘treatment-experienced’). Viekirax and Exviera have been tested in people with HIV and HCV co-infection. Response rates and side-effects are similar to those of HIV-negative people, but some of the drugs in this combination can interact with antiretroviral medications for HIV.
How are Viekirax and Exviera taken?
Viekirax is taken as two tablets once daily (in the morning) with food. Exviera is taken as a one tablet twice daily (in the morning and evening) with food. Most people will also need to take ribavirin pills twice daily, with doses based on body weight.
Recommendations for people with HIV and HCV co-infection are the same as for HIV-negative people. However, Viekirax should not be used with certain antiretroviral medications. Viekirax contains ritonavir and should not be combined with additional ritonavir used to boost HIV protease inhibitors.
People with HIV and HCV co-infection who are not on antiretroviral therapy should not use Viekirax because the ritonavir could cause HIV drug resistance.
The TURQUOISE-I study showed that Viekirax plus Exviera with ribavirin for 12 or 24 weeks cured 92% of people with HIV and HCV co-infection (mostly with HCV subtype 1a).
The effectiveness of Viekirax and Exviera in ‘real world’ use may be somewhat lower than cure rates seen in clinical trials, in part because patients may be sicker or have other conditions that make treatment more complicated.
Health and well-being tracker
Over my treatment experience I will be completing a health and well-being tracker to monitor my side-effects and what my treatment has on my life.
Do Viekirax and Exviera interact with other drugs?
The drugs in Viekirax and Exviera can interact with other drugs that are processed by the same enzymes in the liver or intestines. These include some antiretroviral drugs for HIV, contraceptive pills, allergy medications, antibiotics,