I notice that ribavirin resistance seems to have crept into the narrative here. I am not sure if there is such a thing. I have seen one study in vitro where I believe they produced variants resistant to ribavirin. I have seen nothing which shows that you can get in vivo resistance to ribavirin. I would like to see the evidence if anybody has any?
For years people treated repeatedly with ifn and riba and it was widely believed that resistance to either of those drugs did not develop. In current times, the AASLD guidelines still recommend retreatment with ribavirin for some people who have treated with it before. Evidence from the Harvoni trials confirms that retreatment with ribavirin in some cases does make a difference. So I have to ask myself what is going on here? Is the ribavirin making a difference but just not as big as it would make if it had never been used before? Or is ribavirin resistance in vivo a myth?
I saw my doc the other day and asked him this question. He is now a virology Prof. of standing, the real deal who came all the way through from the early days of the HIV epidemic. He says there is no such thng as ribavirin resistance. Now I am prepared to entertain the idea that he is wrong, but his opinion does carry weight.
On a personal note, I am trying to decide whether or not to add ribavirin to my own tx. From experience I think that it will give me a bad rash. If it is not going to be useful then I would happily forego that horrible experience. So, evidence please for ribavirin resistance in vivo?