hepatitisresearcher

[glucklich]

On the NAy News on Vx950 thread, oyu wrote

Not only would Protease +SOC for clear nonresponders not permanently eliminate the virus but something much worse will likely happen ( to quote as mremeet has properly pointed out some hundred posts ago:  " you will be saddled forever with resistance mutations against this treatment component").: This archived resistance mutations against telaprevir would make it impossible to clear the virus at that important future moment  when finally the next chance to treat with an inhibitor combo like Protease + Polymerase +maybe Nitazoxanide will become available that MIGHT, JUST MIGHT give a decent percentage chance to clear despite the preexisting IFN resistance.

chilling for those who failed.
Are there any ideas out there about what the 'right " thing to do immediately after treatment while the VL is sill very low and any ideas for the next step other than extending treatment somehow.

[FlGuy]

Just to add, the pre-dosing of weight-based riba was immediately followed by doubling the peg (2 x 180) for 4 weeks as well. Then, the rest of tx was 'normal'

[alagirl]

but would pre-dose Procrit as well
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no doubt.  If I wasn't an acute and could have taken the time to ramp up I think pre-dosing the procrit even prior to beginning the riba that was being pre-dosed prior to the interferon would give me a leg up.  I was only able to pre-dose epogen to a much smaller degree because of the more limited amount available to me at the time.  If I'd had three or four weeks with the same procrit availability I have now prior to beginning the riba I think I would be having a far easier time of things and possibly would be ahead of the curve instead of dragging tail behind it like I am now.  I might've "pre-dosed" my bank account too if I'd had a little more time. ;)

[alagirl]

2x the interferon.  Ouch.  My joints hurt just thinking about it.  

[jmjm530]

Curious, what was your viral response the first time around, and what was your dosing?
I didn't pre-dose -- didn't know much in those days -- but did do a combination of high dose riba and double dosing. Was around two logs at week ONE. UND at week 6. I"m guessing I would have been UND sooner had I not had to go completlly off the riba between weeks 2 and 3. In other words, in my case I don't think the double dosing and high dose riba mattered since my week one response was from a single dose and 1200 mg riba. But of course I didn't find out my week 1 result until week 3. Certainly getting faster PCR results is a helpful adjunct to personalized treatment, not that anyone could have pulled me off those drugs anyway once I went into "warrior" mode. But on reflection, don't think I needed the xtras.

[jmjm530]

I don't think in your case pre-dosing riba would have made sense, but pre-dosing Procrit (4-6 weeks prior to tx ) might have. Coulda, shoulda, woulda :)

[alagirl]

Yeah.  The trouble is, of course, that to get the insurance companies to sign off on a large amount of procrit (such as 40,000 units or more per week) you have to show the need for the increased dose.  I wonder if you could even get an insurance company to sign off on paying for the procrit for the purposes of pre-dosing when they see it as a rescue drug.  I'm not certain what a month's worth would cost at that level if you went off insurance to buy it.  I know that when I first was increasing my epogen I thought I was going to have to pay out of pocket once so I priced it and I think it wasn't too bad due to being the generic, maybe $50 I want to say? however, that was at a much smaller strength per vial.  Wonder what the uninsured cost is for epogen in the larger strengths.