Aa
New Approach, Old Drug Show Promise Against Hepatitis C, Research Shows
".....The advance involves two new discoveries. One is that a protein called NS4B is instrumental in binding some of the genetic material, or RNA, and allowing the hepatitis C virus to replicate. The other is that the former anti-itching drug clemizole hydrochloride could hinder that protein, resulting in a tenfold decrease in virus replication with no apparent harm to infected liver-like cells. Because the drug has already been used by people, it is eligible for human testing....."
See: http://www.sciencedaily.com/releases/2008/08/080831151350.htm
Mike
See: http://www.sciencedaily.com/releases/2008/08/080831151350.htm
Mike
Well, first, "Willing" has posted in the past that should he treat again, that he personally would get the most sensitive test available and if I remember correctly would test a week 4, maybe earlier. Therefore, I see his comments as abstract/argumentative and really don't want to continue on with him a conversation that has been going on too long. Not even sure if he takes it seriously any more but I'm afraid some members are and may forgo what are important tests.
Fact is that that senstive week 4 testing is supported by most leading liver specialists as well as by major researchers like Berg, who Willing was very fond of quoting until Berg came out for sensitive and early testing.
Getter: For the average person treating here what would be gained by having a pcr’s test at week 4 and 8 as apposed to just having a pcr done at week 12?
-------------------------
The word "average" is key because early and sensitive testing is only useful if either you and/or your medical team is above average, i.e. you're treating with a hepatologist who knows his stuff.
And as mentioned in another post, one of the good things about MedHelp is that many of us strive for the highest common denominator in terms of treatment and not the lowest. But even if your doc doesn't know a TMA from the AMA, another doc you may see in the future might. Such as an outside consult, or a new doc if treatment doesn't work the first time. And to those that know, this information is important for a number of reasons.
First, RVR (UND at week 4) is predictive of SVR. This is important information for both doctor and patient in terms of how vigorously to treat in numerous scenarios including significant side effects. It also can help determine treatment length as studies keep coming out giving more refined odds on SVR with different tx lengths for those who are RVR and for those who are not.
It can also help the doctor "tweak" dosage by giving earlier indications of tx response, especially in a more agressive tx program. It can even help both doctor and patient make more informed decisions whether to continue of stop treatment in certain cases.
And lastly, early, more frequent, and more sensitive viral load testing will become part of your medical record that can be useful in future treatments as newer studies come out that may be able to use these numbers in ways we still don't know about. A point, btw that Willing has conceded some time ago, but still persists in suggesting these tests are useless.
Just one example is helping ferret out true responders from non-responders for future PI treatments per a thesis put forth by Dr. Mitchel Friedman where he suggested that was sometimes difficult because most only tested at week 12 and someone may have responded earlier only to then have the viremia turn back on. These people he considers responders but in a sense they are hidden responders and end up being misclassified as non-responders.
The question isn't "why" get early, frequent, and more sensitive tests, but the real question is "why not". In most cases your insurance will pay for the testing if requested by your doctor. The more points, and the more accurate the points, the more information a top-level doctor has to direct your treatment and the more info in your chart for other doctors both on a consult basis or in a future treatment scenario. But back to the "average" doctor -- even the average doc is starting to use the week 4 tests more and more. Perhaps in another couple of years the average doc will use the week 8 test as well, or even a week 2 test. Remember not everyone clears the first time.
-- Jim
Fact is that that senstive week 4 testing is supported by most leading liver specialists as well as by major researchers like Berg, who Willing was very fond of quoting until Berg came out for sensitive and early testing.
Getter: For the average person treating here what would be gained by having a pcr’s test at week 4 and 8 as apposed to just having a pcr done at week 12?
-------------------------
The word "average" is key because early and sensitive testing is only useful if either you and/or your medical team is above average, i.e. you're treating with a hepatologist who knows his stuff.
And as mentioned in another post, one of the good things about MedHelp is that many of us strive for the highest common denominator in terms of treatment and not the lowest. But even if your doc doesn't know a TMA from the AMA, another doc you may see in the future might. Such as an outside consult, or a new doc if treatment doesn't work the first time. And to those that know, this information is important for a number of reasons.
First, RVR (UND at week 4) is predictive of SVR. This is important information for both doctor and patient in terms of how vigorously to treat in numerous scenarios including significant side effects. It also can help determine treatment length as studies keep coming out giving more refined odds on SVR with different tx lengths for those who are RVR and for those who are not.
It can also help the doctor "tweak" dosage by giving earlier indications of tx response, especially in a more agressive tx program. It can even help both doctor and patient make more informed decisions whether to continue of stop treatment in certain cases.
And lastly, early, more frequent, and more sensitive viral load testing will become part of your medical record that can be useful in future treatments as newer studies come out that may be able to use these numbers in ways we still don't know about. A point, btw that Willing has conceded some time ago, but still persists in suggesting these tests are useless.
Just one example is helping ferret out true responders from non-responders for future PI treatments per a thesis put forth by Dr. Mitchel Friedman where he suggested that was sometimes difficult because most only tested at week 12 and someone may have responded earlier only to then have the viremia turn back on. These people he considers responders but in a sense they are hidden responders and end up being misclassified as non-responders.
The question isn't "why" get early, frequent, and more sensitive tests, but the real question is "why not". In most cases your insurance will pay for the testing if requested by your doctor. The more points, and the more accurate the points, the more information a top-level doctor has to direct your treatment and the more info in your chart for other doctors both on a consult basis or in a future treatment scenario. But back to the "average" doctor -- even the average doc is starting to use the week 4 tests more and more. Perhaps in another couple of years the average doc will use the week 8 test as well, or even a week 2 test. Remember not everyone clears the first time.
-- Jim
For the average person treating here what would be gained by having a pcr’s test at week 4 and 8 as apposed to just having a pcr done at week 12? I had a standard test down to <10 at week 8, would it have made a difference if I had one before that? and if I was at the max dosing of (180/1200) from the get go what else could be done to that point, increase more riba? without knowing the true cmax of the inf and riba in my system? May this be the reason why that most doctors do not do pcr testing before week 12? I would hope to think that it is up to the treating doctor to be proactive at week 8 because of the bx and first vl base line before treatment begins and if one has started out on a lower dosage there may be a little wiggle room to increase the riba or inf at week 12 without throwing the patient into toxicity.
jasper
jasper
just a curious question, why do you feel that one is throwing money away by getting a sensitive pcr test before week 12? Is it because there is no relevance in viral load during this period because the meds are not at their fullest peak and that the virus is at its highest and lowest replicating state in which you will not get a true reading of the pcr? Thanks in advance!
jasper
jasper
DD : yes, the 2nd of those was the one I was looking for - many thanks! (and, no I don't think there's any way of making links active; that feature dates back to the bad old, pre-ads,pre-glitz days)
I think your claim under AMEN above is pretty solidly supported, eg by the results of this study and references it cites.
Basically, in both chimps
http://www.ncbi.nlm.nih.gov/pubmed/14554088
and humans
http://www.ncbi.nlm.nih.gov/pubmed/10352286
there seems to be a threshold of exposure sufficient to activate the CMI side of immunity, as evidenced by HCV-specific CD8+ and CD4+ T cells, without ever kicking the humoral, AB generating, side of immunity into play.
Once you move above the level of QM, black and white certainty seems hard to come by, and everything turns to shades of gray. One, very pale gray, shade seems to be that living near someone with HCV-AB(many of whom presumably were also PCR+) exposes you to enough virions to raise the hackles of at least part of the immune police. In that study, kids living with at least two HCv-AB +family members, had a much greater frequency and diversity of CD4+ and CD8+ cells specific to HCV epitopes than kids living without anyone with HCV ABs in the house. Mine have all moved out now, but I used to routinely ask for, and fret over, their AB tests. They always came back neg, but I wouldn't be at all surprised if they have HCV-specific CMI activity.
However, I think it's a very long stretch to assume that development of this sort of immune response is associated with any health consequences. It just seems an indication of immunity doing its job, and a sign that the trace levels of HCV routinely reported in saliva, tears, mucus, fishbones, etc. etc. are real but not a threat.
jim:
>and now for early and sensitive viral load testing.
you must be thinking of my evil twin (aka 'Test, baby, Test' willing). He thinks the way to SVR is to drill, er, test, early and often. Me, I still think that as far as guiding soc, one is throwing money away by paying for sensitive tests any time other than w12.
I think your claim under AMEN above is pretty solidly supported, eg by the results of this study and references it cites.
Basically, in both chimps
http://www.ncbi.nlm.nih.gov/pubmed/14554088
and humans
http://www.ncbi.nlm.nih.gov/pubmed/10352286
there seems to be a threshold of exposure sufficient to activate the CMI side of immunity, as evidenced by HCV-specific CD8+ and CD4+ T cells, without ever kicking the humoral, AB generating, side of immunity into play.
Once you move above the level of QM, black and white certainty seems hard to come by, and everything turns to shades of gray. One, very pale gray, shade seems to be that living near someone with HCV-AB(many of whom presumably were also PCR+) exposes you to enough virions to raise the hackles of at least part of the immune police. In that study, kids living with at least two HCv-AB +family members, had a much greater frequency and diversity of CD4+ and CD8+ cells specific to HCV epitopes than kids living without anyone with HCV ABs in the house. Mine have all moved out now, but I used to routinely ask for, and fret over, their AB tests. They always came back neg, but I wouldn't be at all surprised if they have HCV-specific CMI activity.
However, I think it's a very long stretch to assume that development of this sort of immune response is associated with any health consequences. It just seems an indication of immunity doing its job, and a sign that the trace levels of HCV routinely reported in saliva, tears, mucus, fishbones, etc. etc. are real but not a threat.
jim:
>and now for early and sensitive viral load testing.
you must be thinking of my evil twin (aka 'Test, baby, Test' willing). He thinks the way to SVR is to drill, er, test, early and often. Me, I still think that as far as guiding soc, one is throwing money away by paying for sensitive tests any time other than w12.
willing: I think that I can also find links to a few more of these sorts of studies, if you are interested in looking further into this subject. Are these the articles you were referring to, by the way?
everyone: What are the opinions on these two issues: potential intra-familial transmission, and cellular immune reactions to the virus, and other atypical means of either being infected or maybe just reacting locally to the virus. Other studies would be appreciated. There are a few interesting ones out there on both subjects, I believe.
DoubleDose
everyone: What are the opinions on these two issues: potential intra-familial transmission, and cellular immune reactions to the virus, and other atypical means of either being infected or maybe just reacting locally to the virus. Other studies would be appreciated. There are a few interesting ones out there on both subjects, I believe.
DoubleDose
AMEN!!! That's what I have been suggesting for a few years now. Infection can pass in different ways without setting off a chronic, full blown HCV infection, and without triggering blood antibodies. Hence it is invisible to the medical community and to the patient!
DD
DD
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