Genotype 4

[zeke58]

Hello.  Anyone have any experience with Hep C, Genotype 4?

[zeke58]

Thank you Bali.  I'll be sure and look up the links.  The Hepatologist I'm going to see is the head of the hepatitis research department at U of M.  I made the decision to go see her because of the G4.  This whole hep thing is way above my head and felt that seeing this Dr who at least knows about the G4 gives me a better chance for success.  Not sure how I feel about the experimental/research factor, but it feels like no matter what or who is treating, it's all experimental for G4.  Trying to muddle through all of the responses and I'm very grateful for all who contribute.  I am learning.  Slowly, but I do believe I am learning.

[Bali05]

Hi Zeke,

Here are a few links to what I suggested earlier. Maybe something to talk to your hepatologist about.

Alinia (Nitazoxanide) and genotype 4
http://www.ncbi.nlm.nih.gov/pubmed/19135998

Predosing Ribavirin
http://www.hivandhepatitis.com/2010_conference/aasld/docs/1214_2010_a.html

Vitamin D
http://www.hivandhepatitis.com/2010_conference/easl/docs/0518_2010_b.html

Vitamin B12
http://www.hivandhepatitis.com/2009icr/ddw/docs/060509_b.html

b
wk45

[Trish77]

Thanks for the link, Mike - not the detail I'm looking for in what you've posted so will look forward to reading the article.

Trish

[Trish77]

Thanks for the direction to CCO for this.  I'll look there.

I've heard that data on rhesus monkeys however heard other data that puts that in perspective.  At this point, I have a different opinion than you of R7128.  

This is the very beginning of the journey for zeke.  Lots to sort out and a step at a time.

(Good luck with all this, zeke. :)

Trish

[mikesimon]

http://www.clinicaladvances.com/cmexpress_pdfs/gh-article-201101-sup1.pdf

"...Telaprevir alone demonstrated modest antiviral
activity in these patients, with a median decline in HCV
RNA levels of 0.77 log10 IU/mL between baseline and
Day 15. In comparison, treatment with peginterferon
and ribavirin was associated with a decline in HCV RNA
levels of 1.58 log10 IU/mL, and treatment with telaprevir
plus peginterferon and ribavirin was associated with a
median decline of 4.32 log10 IU/mL. This finding suggests
that the 3 agents may achieve a synergistic effect when
used together. The investigators noted that IL-28B genotypes
were not investigated in this study; thus, imbalances
in the frequency of these genotypes cannot be excluded
as a potential explanation for the differences among the
3 groups.
No significant differences in outcomes among the 3
groups were noted at the end of the peginterferon and
ribavirin treatment period. In an intent-to-treat analysis,
the proportion of patients with undetectable HCV RNA
levels was 75% in the group treated with telaprevir plus
peginterferon and ribavirin, 75% in the group treated with
peginterferon and ribavirin alone, and 88% in the group
treated with telaprevir alone followed by peginterferon
and ribavirin for 46 weeks. SVR rates were 50%, 63%,
and 63%, respectively...."

[Bali05]

I don`t have the link at hand for Tela and GT4 however you find it under Clinical Care Options study C210. Again, I also posted it above.

What you are suggesting is a pretty big gamble in my view.
We simply don`t know which drug is going to be available for GT4 and worth
its risks any time soon.
BTW , R7128 has shown kidney problems in resus monkeys and I personally
know someone that was part of the phase 2 trial and developed horrible kidney
problems.The fact is R7128 is still in trial and part of that is to find out if
there are side effects, not something I would want to be part of if I have better options.
.