I think this is a great discussion too, and a subject which I have thought a lot about. I think there's the AASLD recommendations on the one hand and the individual situation on the other hand. If the financial constraints are removed because the person is buying the generics themselves, then the next constraint is safety. These drugs have all been tested for 24 weeks and are safe for most people to take for 24 weeks. So that's ok, so long as the individual can tolerate them for 24 weeks, especially the riba.
So why would I want to do 24 weeks if AASLD says I can be cured in 12 weeks? Well, I am geno1b, treatment experienced with ifn, riba and telaprevir (NS3), non-cirrhotic, age 65, two previous tx and two viral breakthroughs. I have chronic fatigue. I have no life. I want my life back. So forget about 90% or 95% probability of success, I need 100%. I need to get it done this time or my next stop could be a care home. So I am going for the max this time. I probably will not be able to tolerate the riba, but even if I can do the first 4 weeks with riba I'll be happy to get the few percent it adds right at the start when it matters most. I also don't know how I will tolerate the other DAA's. Maybe I'll have to discontinue before the 24 weeks. The path of tx often does not run smooth. All I know is that just about every study shows 100% success for non-cirrhotics who do 24 weeks and that's what I want. 100%. I really couldn't care less if the 2nd 12 weeks is overkill so long as my body can tolerate it. Just having the psychological pleasure of overkilling that stinking virus will make it worthwhile. Em, I get where you are coming from. Whatever it takes.
dt