Research supported antifibrotics - do they exist?

[Hepatitis Researcher]

The problems of treatment failure for SOC/IFN nonresponders and the possibility of reducing future supercombo-SVRchances by introducing archived resistance mutations when using "Pseudomonotherapy" - (that is here defined as using  a single  antiviral agent that is not protected against resistance development by its combo with an IFN/riba component (IFN by definition in this scenario is not sufficiently effective in reducing viral replication so that all the burden to tame the adaptive quasispecies evolution falls on the antiviral)) together with the 61% and 65% SVR rates for the latest triple modality in Geno 1s, have raised concern and the awareness for the need for alternate/additional treatment modalities in many HCV patients and their health care providers. Waiting for future antiviral developments is one route frequently recommended, but for the patients  in current need, our repertoire of additional meaningful approaches needs to be carefully reevaluated. Using antifibrotics to halt fibrosis progression is one concept not proven in large trials but it might well be effective in many, because the mechanisms for fibrosis generation are not intrinsically linked to HCV persistence, but rather to secondary response mechanisms evoked in the chronically inflamed liver, with the stellate cell activation holding center stage in this scenario. The following is one of several possible add on modalities.

[Hepatitis Researcher]

Your cholesterol is low because your liver cells are hampered in their synthesizing activity.  It is not likely that PPC would further lower the total cholesterol in this setting. Plus this can easily be followed.
Yes, the PPC is made from Soy, and if somebody is allergic against soy, it is a no no to use it, like any other soy product.

[merryBe]

yes you are a huge help! It's not often anyone gets the benefit of a vast resouvoir of knowledge on their specific disease. I doubt any other forum in here is so blessed/

that said, got another huge question

I'm wondering HR could you comment on the cholesterol lower aspects of PPC.
Mine is123 total right now, and this, plus the supposed itchy skin reactions (with riba alreafy on board that's a yike) plus the PPC being a soy derivative (allergies for some) ( that's the only source?....well it becomes a little more of a puzzle....wouldn't lowering cholesterol be a possible containdication given the 123?

[scratchinghead]

Thanks! Make sense to me. Better start weaning myself off coffee.

[Whrose]

thanks again for viewpoint and your answer.
the disclosure cause the way i understand it is to expose bias. however when the bias is met with sound principles, does it matter?  we all benefit from the efforts that these conference presentations give to the medical community and ALL the dollars that support them. i don't care if the money came from the mafia!  we need dollars and we need answers.  if you had answered yes to my question how would that change the evidence and science behind all your words?
dear no i would not ask my overweight hepatologist why he is not taking care of himself. i am seeing him for his expertise and solutions to my problems, not as his judge to personal lifestyle habits. but i might make a comment to him in the context of concern if the right moment presented. as for my famous hepatologist and his financial backings to research. yes i would ask. i am curious about these things. it is always within ones right not to answer.  pharm companies that compensate these docs have picked the cream of the crop. it is to our benefit that their research is supported.
in fact i wish you had the $ backing your thoughts and research. prevention of fibrosis will be of such value to our community that it brings tears to my eyes to consider its potential! you are a very nice person and also a dedicated one with intelligence. i would leave my trust fund to dedicated ones like you.
thanks again for all you do.
warm regards

[Tallahassee]

HR,

Thank you very much for chemistry & medical lessons.

I'm still trying to figure out what questions to ask my GI tomorrow ... regarding my low IgM & IgG.  http://www.medhelp.org/posts/show/338367

If you recall, I'm about 6 months post tx (and Hep. C NEGATIVE!!!!) and developed IgM & IgG deficiency. You pretty much gave me peace of mind ... that eventually my bone marrow should recover.  You also said that I should me monitored by a Dr.

So, I'm trying to come up with tests to suggest to my Dr. for my follow up/ monitoring.  

You mentioned:
- Flow Cytometry for B-cells (+ surface IgM & IgG)?

- will I benefit at this time from "Quantative Measurement Immunoglobulins Isotypes" (in order to exclude other humoral Immunodeficiencies)?

- also "Immunoglobulin Electrophoresis"?
--- of course, it is all in addition to repeating CBCs test.

I recently read about IgM-IgG complexes and also B12-IgG-IgM complexes were measured in unique (?) cases with high B12 concentrations (and I have high B-12 levels – over 4000 in May of 2007).

If you recall, my latest RBCs became slightly more reduced ... and I went through mental “exersice” trying to eliminate other, more innocent, causes for my newly acquired anemia... I even took for a week Iron Gluconate, just to make sure that I don't have iron deficiency.

If you may think of any beneficial diet / supplements – please share it – I’ll be grateful forever

Since now, after the treatment, to ask Dr. for blood tests, it is like almost "pooling teeth", I must be very specific, precise, and present my case knowledgeably during my short appointment with the Dr.

Oh, how I wish now that after my biochemistry degree, instead of engineering, I went to medical school... Oh well...  But I decided (and told that to my husband!), if I'll recover and if we'll win lottery, I definitely will enroll to a Medical School, not for practicing medicine, just for more knowledge. :-)

All the best and THANK YOU!

[Hepatitis Researcher]

Thanks for the realistic and kind words. You are surely aware that "legitimate questions" sometimes, if the context has provided them already, are borderline unwise and inappropriate. Whrose, Would you ask your famous hepatologist if he gets paid by the pharmaceutical  companies? You could and you could also ask your severely overweight hepatologist why ihe is not taking care of himself, while recommending anti NAFLD lifestyles to his patients. It will make him more open to prescribe you off label NTZ/SOC on the basis of the conference presentations?No, of course, it will not influence him the slightest.

  The implication of financial interest is of course always that your opinion is shifted in favor of what you get paid for, and that is indeed - human nature, and an essential feature of evolution- often the case.The disclosure clause, now commonly used in presentations of medical material with financial implications, is supposed to help raise suspicion towards the opinions presented.


Mremeeet, Important contributions here, simply aimed at helping other people, like the taste of the Telaprevir pills that you once presented here to help some decide if they were in the placebo arm got knocked down with hostility by others who did not like the slightest air of criticism in that realm.I wonder if anyone else perceived that critical piece of info and  I personally like  the harsh , no nonsense approach to everything, including intolerance to smooth bull that you often displayed, properly, in my eyes, when it comes to treating a potentially deadly disease.