Home Forums Main Forum Experts Corner Resistance Prevalence of Resistance-Associated Substitutions in HCV

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  • #22815
    Avatar photorohcvfighter
    • Guardian Angel
    • ★★★★★
    @rohcvfighter

    Hi Dr. Freeman,

    thank you for this article.
    I have to admit that the information about RAS in this article is somehow puzzling for me, yet having been through the article, my understanding is that for a GT1 patient who relapsed after the SOF/LED treatment for 12 weeks, the alternatives are:
    – either retreat with SOF/LED for 24 weeks (which seems to lead to almost 100% cure rate) // however this information is somehow contrasting the information about re-treatment options presented here http://freepdfhosting.com/b3d39c5e48.pdf on page 14 – Ch. “Re-treatment Strategies after Failure of IFN-Free Treatment”
    – either retreat with SOF/LED+ a 3rd DAA ( which one might this be? VEL?, VOX?, DAC? ) for 12 or 24 weeks.

    Just an idea: would it be perhaps recommended and financially feasible, to treat GT1 patients right from the beginning with a combination of 3 generic DAAs? I would imagine that perhaps adding another ~100$ (that’s just an imaginary cost ) to the generic treatment costs, the risk of relapse will be very very low, so a GT1 patient who might relapse (if treated with SOF/LED only) could save some time, money and stress by not having to retreat.

    Cheers,
    RHF


    In fiecare an HCV ucide peste 500000 oameni.Medicamentele generice pentru hepatita C functioneaza. Nu deveni statistica! Cauta pe Google “medicamente generice pentru hepatita C”.
    HCV kills more than 500000 people every year. HCV generic drugs work. Don’t become a statistic.
    By sharing this Youtube video you might save someone’s life!
    My TX: HEPCVIR-L[generic Harvoni]-India
    SVR52 achieved

    #22817
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    I have little doubt that we will move to 3 drug therapy for HCV treatment targeting NS3/4A, NS5A, and NS5B in the near future. Viekira Pak already does that but is hampered by a weak NS5B.

    All of Gilead’s Sofosbuvir + Velpatasvir + GS-9857; QUARTZ-1 V-pak + Sof; C-SWIFT Zepatier + Sof use this strategy which is simply borrowed from the HIV experience with HAART – Highly Active Antiretroviral Therapy with 3 or 4 drug combinations.

    Maybe ABT-493 + ABT-530 are strong enough without Sof but it’s hard to imagine they would not be better again, maybe even perfect with Sof.


    YMMV

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