Aa
Interesting read from EASL
http://www.clinicaloptions.com/Hepatitis/Conference%20Coverage/Vienna%202010/Tracks/HCV/HCV/Pages/Page%201.aspx
excellent discussion - thanks for posting! I like the case/discussion format - it's funny how much it resembles a lot of what goes on around here. These are the ranking hepas world-wide so their comments really drive home what is/is-not known about tx strategies, progression etc.
The comments on IL28B seem very on point. Though this is clearly the latest buzzword in the hepa world it's clear that the patient impact is *not* clear yet.For example the forthcoming article Mangia'10 (Gastroenterology - in press, horrible long url)
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WFX-5070DFC-7&_user=10&_coverDate=06%2F02%2F2010&_rdoc=70&_fmt=high&_orig=browse&_srch=doc-info%28%23toc%236806%239999%23999999999%2399999%23FLA%23display%23Articles%29&_cdi=6806&_sort=d&_docanchor=&_ct=114&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=17962563ff8478696fa31786a0d49827
shows that among RVRs IL28B didn't matter much, but among those who *didn't* RVR it made a huge difference (CC=87%, CT=67%, and TT=29%, P=0.0002) This was in G2/G3 but since I didn't RVR I poked around a bit as to how to determine whether I'm a CC, CT or TT. Turns out you can't get there yet from here as best I can tell. Of the three companies I could find that provide personalized genomic testing (23andme, pathway genomics and navigenics) only 23andme comes close to testing IL28B testing and they don't look for the main SNP but for rs8099917 which is another "nearby" SNP that allegedly is closely correlated to the main il28b SNP.
https://www.23andme.com/health/Hepatitis-C-Treatment-Response/techreport/
The comments on IL28B seem very on point. Though this is clearly the latest buzzword in the hepa world it's clear that the patient impact is *not* clear yet.For example the forthcoming article Mangia'10 (Gastroenterology - in press, horrible long url)
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WFX-5070DFC-7&_user=10&_coverDate=06%2F02%2F2010&_rdoc=70&_fmt=high&_orig=browse&_srch=doc-info%28%23toc%236806%239999%23999999999%2399999%23FLA%23display%23Articles%29&_cdi=6806&_sort=d&_docanchor=&_ct=114&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=17962563ff8478696fa31786a0d49827
shows that among RVRs IL28B didn't matter much, but among those who *didn't* RVR it made a huge difference (CC=87%, CT=67%, and TT=29%, P=0.0002) This was in G2/G3 but since I didn't RVR I poked around a bit as to how to determine whether I'm a CC, CT or TT. Turns out you can't get there yet from here as best I can tell. Of the three companies I could find that provide personalized genomic testing (23andme, pathway genomics and navigenics) only 23andme comes close to testing IL28B testing and they don't look for the main SNP but for rs8099917 which is another "nearby" SNP that allegedly is closely correlated to the main il28b SNP.
https://www.23andme.com/health/Hepatitis-C-Treatment-Response/techreport/
Good stuff there, my friend.
I am glad to see your doctor is such a high achiever. I think we would all clear if we had Kwo or Zeuzem as doctors. Pawlotsky, I am not sure of -- maybe he is too much of a pragmatist.
He said regarding basing the time to treat of the date the patient clears:
"Regarding the case, I believe the INDIV-2 approach is truly interesting, but likely too complicated for clinical practice"... "This is already sometimes difficult to remember (meaning treating for 24 or 48 or 72 weeks) for treating physicians who do not see a lot of patients with chronic hepatitis C."
Well, why is it that we patients can read all of the most current information on hep C at Clinical Care Options but our doctors just don't or won't?
frijole
I am glad to see your doctor is such a high achiever. I think we would all clear if we had Kwo or Zeuzem as doctors. Pawlotsky, I am not sure of -- maybe he is too much of a pragmatist.
He said regarding basing the time to treat of the date the patient clears:
"Regarding the case, I believe the INDIV-2 approach is truly interesting, but likely too complicated for clinical practice"... "This is already sometimes difficult to remember (meaning treating for 24 or 48 or 72 weeks) for treating physicians who do not see a lot of patients with chronic hepatitis C."
Well, why is it that we patients can read all of the most current information on hep C at Clinical Care Options but our doctors just don't or won't?
frijole
Might have to go this route.......
http://clinicaloptions.com/Hepatitis/Conference%20Coverage/Vienna%202010.aspx
http://clinicaloptions.com/Hepatitis/Conference%20Coverage/Vienna%202010.aspx
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