Dear andiamo 1
The drugs really look promising but interferon is not as bad as you think. all adverse effects are reversible when you stop it. However I am intersted in PI .Are they available? By what name ? I am from India.
Many of the adverse effects are not reversible. There are plenty of people that have permanently damaged their thyroid. Having taken interferon for 7 out of the last 20 years, I can tell you that it is devastating on the patient and the family.
They are only available in drug trials at this time, since none are FDA approved as yet. I am not sure what the status is in India.
I also think interferon is not that bad, and feel that Ribarvirin is the nasty one in the mix. That is to some extent what concerns me about the additional mix drugs.
To me, there is a fundamental difference between Hep C and HIV and that is, that many people with Hep C decide not to treat, that the side effects outweigh the benefits. Whereas with HIV, people feel they have no choice.
Accordingly, I think there will be the most benefit overall, if more people can be convinced to treatment. To that end, the focus should be on reducing the side effects of existing treatment, while looking for replacements for existing treatments, rather than add ons (which may scare away more people). In this respct, I think Albuferon could be absolutley briliant, and that similar drugs are the best way to go, along with research into some form of other future treatment not involving Ribarvirin or one day, interferon(vaccine or similar).
Another way of puting it, if tommorow we had the choice between:
1. An add on drug that will raise success rates to 90% for those who can stay on treatment; or
2. A replacement for existing treatment with minimal side effects, but only a 40-50% success rate,
IMO 2 would save and improve the lives of far more people than 1. With minimal side effects, there would be far fewer dropping out of trials as well.
Another way of puting it, will PI's just lead us to an HIV type blind alley - being that of maintaining a low viral count, or controlling the virus, while needing to constantly change treatment due to mutations - good for Pharmaceutical companies I guess, as many different drugs get rotated. A blind alley for Hep C I fear, because unlike HIV, many Heppers can live without virus maintenance, and hence, won't lower their standards to accept the side effects.
Where did you hear that PIs lead to a low viral count when used with HCV? All the studies show that SVR is SVR and RVR is RVR no matter if PIs are used or not. There are plenty of Prove 1s that have been SVR for over a year now.
I see one of the world famous Docs and he couldn't disagree with you more about the desirability of continuing with SOC drugs. I have own experience to go by: I treated for 7 out of the last twenty years and the impact of that was devastating on me and my family. I had to do it, since I was progressing rapidly to stage 4 and by treating repeatedly, I was able to maintain stage 3 since 1992, with very little progression.
I think we both want the same thing: a cure for this disease that helps a large percentage of people.
As far as your choice 1 and 2, I certainly agree with you about 1 being optimal.