Will the virus in general population mutate to be resistant to PI's?
I was thinking about this recently. If somebody try's a PI, and fails / builds resistance to that PI, then re-infects somebody else in the general population with Hep C - won't the disease gain resistance to that PI? The new mutation could spread, and become the standard for Hep C (given the new resistance, will make it live longer). Are PI's a short term fix, that the virus will eventaully become resistant to?
That’s a very good question, and one that others are surely better qualified than I to answer. However, isn’t that why PI’s aren’t used as a monotherapy? My limited understanding is that PI’s are always used as an adjunct to standard IFN/riba treatment so the IFN will then cull escape variants produced via PI use. Whether this addresses *all* mutation production is interesting; perhaps ‘Willing’ or someone more familiar with this side of things will offer their thoughts. I hope they are sequencing results in trials to watch this as they proceed; it would be pointless as well as frightening to go forward with production if this were true, wouldn’t it?
It is well known from phase 1 trials of inhibitors including Telepravir that there is a mutation and rebound after 3-4 weeks.
The answer is combination threapy whereby the wild type is knocked out quickly with interferon supressing any variant until it litereally gives up and dies.
Ribavirin is crititcal to induce genetic sampling error to prevent a successful variant forming whilst the wild type is being knocked out.
The key to SVR is isto knock it out quick before it can regroup.
P.I resistant strains will be offset by lower infection rates and higher cure rates.
Remember Hepatitis C rates are reducing not increasing.
Copyright 1994-2016 MedHelp International. All rights reserved.
MedHelp is a division of Aptus Health.
This site complies with the HONcode standard for trustworthy health information.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.