HCV: should i begin treatment, or wait for VX-950?

[niceguy2007]

hi everyone,

i got my test results back...

This time, ALT was 103, but AST was 28, virus load is 12,000 IU/ml.

A month ago, ALT was 24, AST was 18, virus load was 13,000 IU/ml.

i'm 25 years old...probably got virus within 4 years ago.

Now the doctor is pressing me for treatment, but i'm considering waiting till the VX-950 comes in.

What do you guys say?

[mremeet]

Bill I agree with you that HCV does impose an emotional toll that must be factored into the decision too. Speaking for myself, HCV caused a great deal of stress in my life long before I even found out I had it. Chronic fatigue, brain fog and insomnia plagued me from the time of infection when I was 17 up until when I found out I had it at age 31. It was like some mysterious anchor around my neck during the years of my life that should have been the best. After that, on some level the stress was decreased because I finally knew what I was dealing with. But of course a new form of stress arose knowing this disease was slowly taking me down, combined with the troubling aspects/prospects of current therapy. Meanwhile, the various parasitic maladies (insomnia, fatigue, fog) continue to contribute to a lower quality of life.

But with all of that said, I also agree with jim. If I were niceguy, was only 25 yo, had an F0/F1 liver, type 3, low to moderately elevated liver enzymes, no other major health problems, didn't drink or drug...then I would not be overly worried at all. I would understand full well that I was largely in the driver's seat, and that I had a very slow moving disease that largely can be successfully managed via good health habits. I would also know that the worse case scenario of waiting 2 years and all of the PI's (including SCH 503034) turned out to be an abject false hope (which I think unlikely), then I wouldn't really be behind the power curve that much. His liver and overal disease histology is unlikely to change much in that timeframe, he'll still be young and all that implies for excellent treatment response, the existing SOC will still be available, and any minor liver damage he has is likely completely reversible if he sucessfully completes treatment. Couple this scenario with the decision to treat immediately and the usual risks of failing treatment (remember approx 15-30 people out of 100 still FAIL current therapy) and the semi-vague possibility he could be saddled with short term or even serious long term health problems associated with IFN and/or riba.

I think in balance if I were in his shoes and knew all of this, I would probably opt for holding off for a year or two and see what pans out. To me that would be the least stressful thing to do, which could also result in a less stressful and more successful treatment course in a few years hence.

[jmjm530]

Kalio: Some of those advising you to wait on drugs that are still in trials did the treatment already and CLEARED the virus, they did not "wait" on better drugs like they suggest you do."

You're again insinuating a double standard for those that don't agree with you. I've only advised those with little or no liver damage to wait. I had stage 3 liver damage, and frankly to do it all over again (if I had a crystal ball and knew what I know today) I might have still waited. There is no double standard here, but a single standard and it has to do with liver damage. This has been a pretty civil discussion so far, but you do have a tendency to raise the heat with misleading and personally directed statements like above.


Kalio: THey advise you to wait until you have MORE liver damage (stage 3) before you treat, but studies show more damage lessens your chances of clearing the virus.
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Actually most of the recent stuff I've read does not rate liver fibrosis as much of a factor until stage 4. If you have any recent studies that contradict this please post.

[mremeet]

No one said or implied for niceguy to wait until he was F3. And the opinion I offered to niceguy is exactly what I've been doing myself for nearly ten years (not the mere one or two suggested by jim and myself). Waiting for a better treatment to come along than the current SOC. And I decided to wait because I assessed my disease progression (which is realtively mild, F1 liver) and wasn't thrilled with the current SOC. Niceguy is asking for personal opinions; just give yours and avoid throwing out an array of red herrings and straw men by misquoting people.

[Bill1954]

Jim- one of us is obviously displaying bias; thankfully it

[Bill1954]

BTW, this is the forum at it

[jmjm530]

Bias??? Me, you, anyone. LOL.

Again, I agree with a lot of what you say, but all I think Mre and myself are saying (at least in part) is for those who can wait (little or no liver damage) to just wait *another year or so* to evaluate the trial data. Not wait 3-5 years hoping in the dark that the magic bullet is coming, just wait another year for the SVR data to roll in.

If things don't look so hot, then sure, reevaluate the decision to treat with more conventional drugs. If they do look good, well, a reasonable decision might be to wait longer while being monitored.

Your case, of course, is quite different, and I know how much thought you've given the various alternatives. You and I have been through this war together from the beginning and I can't tell you how much I admire your attitude in the face of having to fight still again. Don't think I could have handled the same situation with so much maturity and composure.

-- Jim