What are the options ?

[bahamasnut]

My husband is geno 3 and finished 24 weeks of tx and in week 23 had a breakthrue  what are is options will the new drugs be avaliable to that genotype ???

[desrt]

Note in the second article the reference to three different sites on the IL28B gene. As far as I know, the LabCorp test currently available only tests the one SNP.

[desrt]

http://www.natap.org/2011/HCV/021611_02.htm


I've posted these two a couple times before.

[desrt]

http://www.gastrojournal.org/article/S0016-5085(10)00841-3/abstract

[orphanedhawk]

Although we don't know how long until the new oral treatment~polymerase inhibitors~ become available ( it could take years) or testing will begin for non-naive tx patients, this could be the answer~only not now.
Sorry not to be of more help.
OH

Pharmasset: 98% to 100% Cure Rates
—Alan Franciscus, Editor-in-Chief

GENOTYPES 2 & 3
In July the SVR data from the group of HCV genotype 2 and 3 treatment-naïve patients was released.  In this part of the study patients were treated for 12 weeks with the triple combination therapy—PSI-7977 (400 mg QD), pegylated interferon and ribavirin.  Twenty four out of twenty four (100%) of the patients who completed treatment became HCV RNA negative (lower level of detection (<12 IU/mL) 24 weeks after completion of therapy (viral cure).  Note:  one patient who only completed one-week of therapy dropped out and was lost to follow-up.  This patient was omitted from the study results.  

[lynda607]

Isn't the IL28B designed for genotype 1 only at this time?  At least that is what I deduce from the Labcorp test menu.  

"IL28B genotype is only one of many factors that can influence response rates to pegylated interferon/ribavirin therapy in HCV genotype 1 infection and should be interpreted in the context of other clinical factors. The mechanism by which the IL28B genotype mediates pegylated interferon/ribavirin treatment response in HCV genotype 1 is not yet understood and is the subject of intense research. The impact of the IL28B polymorphism on response rates in HCV genotypes other than genotype 1 is still being investigated.

[desrt]

Taking the IL28B test before his next tx might give you some idea of how aggresively he will need to treat.
Besides the other factors Willy50 brought up in your previous thread
http://www.medhelp.org/posts/Hepatitis-C/breakthrue/show/1608751#post_7311802
such as controlling insulin resistance and using Alinia 'off-label' there is one other idea that doesn't get discussed much since it's not really understood. It's been known for a long time that a small % of patients who switch PegIFNs (Pegasys to PegIntron or vice versa) will get SVR on their second attempt. Since it's a very small % and the 'why' of it isn't understood it doesn't get much discussion.

[lynda607]

So far, the only new drugs approved by the FDA and available for use are Incivek and Victrelis and they are not approved for genotype 2 and 3.

Trials showed genotype 2 responded reasonably to the protease inhibitors but genotype 3 did not.

As discussed in one of your previous threads, tweaking or tailoring treatment with interferon and ribavirin may bring success or researching  what is available in trial for genotype 3.