At the moment I suspect the answer is that no one knows because because as far as I know it hasn’t been researched let alone trialled.

The question of sofosbuvir monotherapy has been researched and trialed in the Pharmasset trial ELECTRON. This trial had an arm :
“PSI-7977 400 mg monotherapy for 12 weeks (n=10 GT2/3)”
(sofosbuvir used to be named PSI-7977 before Gilead bought it)
http://www.prnewswire.com/news-releases/pharmasset-announces-further-expansion-of-electron-trial-in-hepatitis-c-131441993.html

Here is one report from that trial, coincidentally involving Prof Gane:
http://www.elpa-info.org/elpa-news—reader/items/sofosbuvir-demonstrates-high-response-rate-in-interferon-free-combo-with-ribavirin-and-gs-5885.htm
“However, sofosbuvir monotherapy or sofosbuvir plus reduced-dose ribavirin for 12 weeks, or sofosbuvir plus standard-dose ribavirin for just 8 weeks, only cured about 60% of treatment-naive genotype 2/3 patients.”

Gilead advise that sofosbuvir not be used as a monotherapy and they have trials that back this up. Whether you love Gilead or hate them, the homework was done on sofosbuvir. You really have to go back to the early trials done by Pharmasset to get the full history on how sofosbuvir was tested as a monotherapy and that option was quickly excluded from later trials as being not viable.

dt

On the other subject of using Sofosbuvir as a prophylactic until something else comes along, probably not.

The “nuke” that Prof Gane is referring to is indeed Sofosbuvir which is a “Nucleotide analog”. It is fairly unique in the way it operates as it effects the HCV virus at two points. This does make it fairly immune to resistance but not totally so. So long term use as is being proposed could result in resistant strains developing.

Gaj – I don’t think resistance would be a problem because a cocktail of drugs would be used in a maintenance regime, each countering the resistance of the other, as is done with HIV.

I’ll come to that in a moment. First to the question of using DAAs prophylactically. I asked this some months back here. You can read the doc’s response for yourself.

Yes you did bring up the topic Chester, and it is a good one. While the doc put forward options that he would prefer, I think that it’s good to have all options on the table and scrutinized to the depth that satisfies those still curious, if possible.

dt

best I can see the majority who fail don’t reach UD during
the 12 weeks they are usually 12 throughout

I don’t agree Sir. People do routinely reach UND without all the virus being gone. The PCR test just isn’t sensitive enough to detect what’s left. If we had a test that really could detect every virus then it would be much simpler. We’d know when we got the UND result that we could stop tx.

dt

However, I wasn’t always that way when first diagnosed, again like Ariel, I was in shock and very vulnerable.

And that’s the trouble. None of us are clued up when we’re first diagnosed. I was completely stunned for some time, outwardly normal but inside like a zombie. That is the exact time when something bad is most likely to happen, simply because you don’t understand what is going on and you have to trust the people appointed to your medical care to do their jobs. As we’ve all found out, that’s a lottery.

I wasn’t unduly harmed. That was mostly luck. On the downside, a lot less was known about 10 years ago, so a lot of suffering happened because nobody knew any better. But by 2012 they did know better. I think that any doctor who prescribes interferon nowadays without first doing genetic testing of the IL28B allele is negligent in their duty of care. Yet this is still going on all across the UK. I got my own genetic test done via the ’23andme’ website. Oh yeah, by 2012 I was clued up. If you are a CT or a TT then interferon is not suitable for you. That is grounds for demanding treatment with the DAAs.

Completely agree with your post LG. Mop up the virus first. Mop up the bastards next. Clean out the whole damn house.
dt

” Have woken up sneezing, but not a cold”

Now that you mention it LG – I have had the sneezes throughout, at any time of the day. It’s not a cold and I don’t get hay fever. Comes with intermittent watery runny nose. It’s not something I ever had except on this DAA tx.

So clock another side effect – sneezing.

dt

Good for you Em. Really appreciate your sharing your journey here. Quite a few of us will be getting to the post EOT anxious wait stage in the near future.

dt

For the technically challenged –

Find a friendly young person to do it for you.
Where there’s a will, there’s a way.

dt