Thanks Lynne. It seems you are not much further ahead in treatment than I am. I will finish my 12-week course of Twinvir on Saturday. I will also post my results EOT. The best way to rebut Prof Gane is to show that that people using generics containing unlicensed Chinese-made ledipasvir (which seems to be the generic drug Prof Gane is most concerned about) can achieve SVR rates comparable to the equivalent branded medicines. People on the branded medicines, as well as people on generics (licensed and unlicensed), can relapse and no-one is expecting the generics to actually do better than the equivalent brand medicines. So stories of occasional relapse on generics do not call into question the efficacy of generics any more than occasional relapses on brands call into question the efficacy of the brands. What matters is to establish an overall picture of SVR rates for generics, particularly the unlicensed generics, which is comparable to the brand versions; that can only emerge if generic-users share their post-treatment results, whether as part of a formal study, as I understand Dr Freeman's to be, or not.
Asif – thanks for your post. My on-treatment results have been fine. Pre-treatment my VL was 1.8 million with ALT 176 and AST 106 . By week 4 of treatment my VL was undetected and my ALT and AST were both back in the normal range. At week 8 of treatment I remained VL undetected. However, according to Prof Gane little reassurance can be obtained from on-treatment results. What matters is the post-treatment results. This is because where ledipasvir is combined with sofosbuvir, which it usually is, Prof Gane says the sofosbuvir may be effective while the ledipasvir is not. In this situation, according to Prof Gane, the sofosbuvir alone can maintain viral-suppression as long as treatment is maintained but when treatment is finished if the ledipasvir component of the medicine was ineffective the virus will then spring back causing relapse.
Chapel - thank you for posting the link. I agree with you that Prof Gane's remarks seem to suggest that one way to respond to relapse - should it happen - is to go on permanent, lifelong sofosbuvir treatment, which alone should be enough to maintain viral suppression, if not cure - a bit like I understand that HIV patients take permanent, lifelong viral suppression medication. Is this correct? Could this be a way of dealing with relapse?