For Null Responers and Triple Tx failures...must read

[nowhine]

This is a very good presentation, with audio, regarding reasons, and possible solutions, for null responders to previous SOC and those who have failed new triple tx. It was posted in a previous thread by epicrose. I thought it might be worth bringing to the top. Any thoughts or comments??????

I have copied and pasted the post from epicrose- see below. Thanks epicrose.

http://www.medhelp.org/posts/Hepatitis-C/DID-YOU-HEAR-THE-GOOOOD-NEWS/show/1668577

I failed triple (incivek) Oct 2011.  GT 1a.  IL28B's CT

I'm now looking to trials.  I'm also trying to figure out the reason for my breakthrough on week 12.

There's a great paper discussing resistance.  Basically, it states Resistant Associated Variants (RAV's) return to WT depending on their fitness.  If they're extremely fit, they'll remain the dominant virus.

Dr. Pawlotsky, author, wrote an HCV resistance paper (attached).  He states the two protease inhibitor sub-groups, linear and macrocyclic, are similar chemically and would share extensive cross-resistance.
  
Pawlotsky's theory is Tx Failures w/Triple Combination with DAA's is caused by insufficient response to IFN, which in turn causes an uncontrolled growth of DAA-resistant HCV variants.  He states to prevent Triple Tx failure, he recommends;
1) high dose of IFN/Riba with a protease inhibitor;
2) quad therapy to increase barrier to resistance to DAA's (w/IFN/Riba);
3) an IFN-free therapy with multiple DAA's.

http://74.43.177.57/courses/2010/pg/pawlotsky/player.html

Happy Reading! .

[curiouslady1]

Thanks a lot Aaron!  I have added the info on the drugs I am taking to my journal and emailed my on line friends who are waiting their turn.  Hope you are well and soon completing successfully yourself.  

[curiouslady1]

Thanks a lot Aaron!  I have added the info on the drugs I am taking to my journal and emailed my on line friends who are waiting their turn.  Hope you are well and soon completing successfully yourself.  

[Aaron57]

Would like to see the Genosure test come to fruition and be accepted by the medical community .. As it was only released to the public last August .. still might take a while

Many doctors are not aware of it kind of like the IL28b was ..a few years ago ...  

Good luck EC getting your data and hopefully you will choose wisely when it comes to a CT ... they are not created equally ...

If you are not a member of Clinical Options .. you might want to check it out ... free registration .. lot's on resistance & especially this up to date  AASLD 2011 update on PI resistance released Jan 4 this month ... might be worth your time ...

http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/HCV%20Resistance/Expert%20Viewpoints/Expert_Viewpoint_1.aspx

Topics covered include:

New data on resistance to boceprevir and telaprevir
New data on resistance to second-wave and second-generation HCV protease inhibitors
Key findings on resistance to daclatasvir, an NS5A inhibitor
Current understanding of resistance to PSI-7977 - a nucleotide polymerase inhibitor
New data on resistance to oral combination HCV therapies

Cheers

[candyce1953]

I can't get the website to open?

[burned74]

Thank You for reposting . This slideshow link is excellent.

[frijole]

nowhine.  

I will download and read later...... but isn't this what you just did except not high-dose INF?  Do you think you had low doses of the trial drugs?   Have you ever done high-dose INF?

I need something to read tonight during the presidential speech.  I just can't stand any politics and I know hubby will want to watch it!  (Not trying to start a political discussion , honest)