Will failed treatment breed a more resistant virus?

Will failed treatment breed a more resistant virus to future treatments? For example, if a person were to fail to attain SVR with Ribavirin and peginterferon, would that breed a virus that is more resistant to future combination therapies such as protease or polymerase inhibitors given along with Ribavirin and peg-interferon?

[sunshines76]

There is no a definite answer, but check this article out:
http://www.heart-intl.net/HEART/Hepatitis/Comp/HCV-resistanttheropy.pdf

[sunshines76]

From http://www.natap.org/2009/HCV/010809_01.htm

"Emergence of drug resistance in HCV must be considered to be a major threat. Furthermore, many of the resistance mutations to PIs and nucleoside analogues may produce cross-resistance to other compounds within the same drug family, which may complicate rescue-treatment options. The length of persistence of HCV resistance mutations after discontinuation of treatment must be investigated."

and

"Because it is possible to eradicate HCV from the host, it was initially thought that with regard to treatment, "the first will be the winner," which meant that the first HCV drug to gain approval would decrease the chances of success for any other drugs that arrived later. However, as more evidence demonstrates the challenge of drug resistance and the need for drug combinations, it is clear that there will be a place for many treatment compounds. In fact, multiple drugs from distinct drug families will be needed, especially if therapy without pegylated IFN is desired. These drug combinations would ideally be constructed with compounds that exhibit complementary features, such as compounds that have distinct drug resistance profiles targeting either the same enzyme (convergent therapy) or different enzymes (divergent therapy). "

[sunshines76]

And another piece of info you might find interesting: https://www.niddkrepository.org/niddkdocs/HALT/MOOP/MOO_K16_HCVBreakthroughAS_12-27-07.pdf

[Trinity4]

Some think resistance to peg and riba occurs with failed treatment.  I don't or there would not be any SVR's for those who treat multiple times and peg and riba would be ineffective in the drug trials for non responders.   Resistance to the PI after failed treatment is a different story.  They don't know a whole lot yet, but they do know it happens.

Trinity

[Gordo1977]

Good question

Many folks that swear by herbal  supplements think yes after the virus has gained resistance to a drug it becomes stronger…I would hope not do due to the fact I was a nonresponder to treatment with peg-riv.

Gordo

Sunshines76 ,thanks for the link.

[Bali05]

It`s basically what Trinity said.This was one of my key questions before starting tx
and my reputable hepatologist told me there is no known additional resistance
created by SOC.