I’d hope so if they don’t have the necessary technology themselves. They seem to behave like professionals from what we have seen so far.

I guess we will be much better informed after a few months as the SVRs roll in. I don’t anticipate any shocks, to be honest.

And a doctor should just keep his mouth shut if he has any doubts? He’s only saying that the chemicals from Bangladesh might not be up to scratch, not damning the properly licensed components at all, including the ones that many of us have benefited from.

By saying this:

Of particular concern is the recent availability of generic ledipasvir from Bangladesh (either separately or coformulated with sofosbuvir). Unlike the manufacturing of sofosbuvir, which is relatively simple, ledipasvir is very complex, requiring almost 20 separate steps. One critical intermediate step is Spray-Drying Dispersion, where the ledipasvir chemical is mixed with another substance to improve solubility. Without this step, the nal ledipasvir drug will not be absorbed when taken by mouth. Spray-drying for ledipasvir requires large purpose-built facilities, of which only a few exist in the world and none in Bangladesh.
It therefore seems likely that generic combinations of ledipasvir and sofosbuvir from Bangladesh will only contain active sofosbuvir. As a result, although the hepatitis C will disappear during treatment (because of the active sofosbuvir), it will relapse after treatment is stopped (because of the lack of active ledipasvir). Secondly, individuals need guidance on what treatment is best for them.

he is only talking about one particular problem that has caught his eye. Maybe you don’t like some of the implications, but if there is any doubt, I would prefer my doctor to at least air the concern.

Personally, I don’t agree with the second paragraph – if the ledipasvir was completely useless, the virus would not disappear during treatment (except for some genotypes in combination with ribavirin). However, if it was not optimally absorbed, it might make the long term outcome unfavourable for some patients.

I think he’s overstated his case, but that he did the right thing by pointing out discrepancies in the unlicensed manufacturing process that could conceivably affect the effectiveness of the drug. Better to go with the licensed generics that seem to be working so well and cost about the same for us.

Since sustained hyperresponsiveness of dendritic cells is associated with spontaneous resolution of acute hepatitis C, then I’m going to say a good option would be pre/probiotics.

http://www.ncbi.nlm.nih.gov/pubmed/?term=Sustained+Hyperresponsiveness+of+Dendritic+Cells+is+Associated+with+Spontaneous+Resolution+of+Acute+Hepatitis+C

Since HCV core protein is a pro-inflammatory TLR2 ligand; (this allows the immune system to recognise the virus and respond appropriately.) Chronic infection means that the virus has managed to subvert these responses. So supplying TLR2 ligands may be a way of switching back on the responses the virus has managed to subvert. So I’m going to say…spirulina. 4 out of 30 patients cleared the virus with spirulina in this trial

http://www.biomedcentral.com/1471-230X/12/32

And since hep c is glucose dependent, a low carb diet can also help.

P.[/quote]

Price, You clearly don’t have a clue of what you are talking about – no informed person would quote such specific details from isolated papers chosen out of context and use that information to give treatment advice.

Your behaviour is ignorant and deceptive. Fortunately in this case, your directions are essentially harmless (apart from the spurious low-carb recommendation), but I sincerely recommend staying away from playing the expert on medical topics of which you know less than nothing.

You could hurt someone one day.

You may have a point there, as breast cancer victims tend to be seen as innocent and some of them die from the disease while they are still politically attractive, whereas on the other hand, most HCV sufferers don’t die from the disease, tend to die later if they do, and in general, can put off being treated for quite some time with no ill effects. It also doesn’t help that most of them caught the disease through the stupidity of youth or criminality or ignorance (not the poor sods who got it from doctors, though), which earns the condition a hell of a lot less sympathy from the general public. It’s a bit like smoking in that way.

A further point is, as I have noted before, that certain drug treatments for other cancers and conditions run to prices at similar levels and higher to Gilead’s gouging. They are not alone in this game at all, and stand out partly because they were successful in their bet on a disease that potentially has a large market.

But your perception has a grain of truth in it. HCV is a drug users’ disease that is hard to market well, whereas breasts are easy to sell and very popular with their owners and close associates. People could very well respond more strongly if such treatment was similarly overpriced – although these days, the common person seems to be very content to act and vote against their own interests.

Who can say?

That is one piece of subjective anecdotal evidence. It doesn’t constitute a scientific demonstration of any kind. I have exactly the opposite experience – also useless evidence, so I don’t use it in argument. Further, viral load changes all of the time and dropping by half in two years means approximately zero according to our current understanding.

I know for a fact that the days I fall off the carb wagon heavily are sure to be followed by digestive system failures and related pains.

That is nothing magic. It’s called “eating too much” and has no relation to the question we are arguing.

Your advice is based on a profoundly ignorant understanding of the paper you quote. You have no idea of what you are saying and you are being reckless publishing such recommendations.

The paper you quote proves nothing of what you claim.[/quote]

Just stop it A.L. Subjectively, I find your language on this forum unacceptable. Objectively, it is completely unnecessary.

In order to challenge someone’s interpretation of the research, you do not have to adopt such a confrontational approach. You continually project emotions onto people. I’ve been subjected to your personal attacks and had you subscribe emotional responses to me on several occasions that simply were not the case. And as I suffer from PTSD I really don’t appreciate it. But I recognise it for what it is.

Bullying.

[/quote]

My language is far more acceptable than that used against me in the past when I have commented. As far as your accusation of me being a bully, that is more a demonstration of victim culture that is one of the uglier aspects of modern western countries. If you don’t like direct discourse, stay out of them, but whatever you do, please don’t complain because you don’t like direct expression of opinion. And to use your words, “Don’t project emotions onto people.”

I’m not going to thank an ignoramus who concludes from a scientific paper, and then goes on to advise, “You can lower your viral load before starting your next treatment by eliminating carbohydrates from your diet.” He says “eliminating carbohydrates”, which is straight up absurd. And then goes on to say “This study proves it…” Again, utter ignorance. In this field, there are very few single papers which prove anything, hence the enormous amount of repetition and variation of trials and experiments. His utterance, at the very least, misrepresents the scientific process and misleads people into making incorrect deductions from single studies. There is no room for misplaced politeness here, just as we don’t warn someone walking into traffic, “Excuse me, you are about to be hit by a bus.”

Well, sorry but I’m not copping your shit. Here’s a tutorial on how to communicate on the internets. Your response could have gone something like this.

“Thanks for your contribution Price but I have to disagree with your interpretation for reasons x, y and z.”

Come on, it’s not that fucking hard. I don’t post on this forum as much anymore partly because of you.

Are you serious? This is an open debate. When was the last time someone walked out of parliament because they didn’t like the tone someone else was using? It reeks either of inexperience in debate, or of the new trend to shut down debate because one disagrees withanother’s opinion.

If I’m feeling generous I might…..and I do mean might….contribute what I can to your request for information about how long to get over the FX of Tx.

But at the moment, I don’t feel so inclined.

What you have just expressed can be described as passive aggression, threatening to withhold a favour unless I comply. For me, such a threat is no problem, more an illustration of a character trait, but I don’t want to shut you down because of it, although it does come as a surprise that someone claiming to have PTSD should be so aggressive.

I’m direct, informative, don’t swear, and argue well within the bounds of decency. You can’t ask for a better interlocutor.