Hepatitis C Support Group
Hepatitis C is a blood-borne viral disease which can cause liver inflammation, fibrosis, cirrhosis and liver cancer. The hepatitis C virus (HCV) is spread by blood-to-blood contact with an infected person's blood. Many people with HCV infection have no symptoms and are unaware of the need to seek treatment. Hepatitis C infects an estimated 150-200 million people worldwide.
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I thought this article was interesting and a worthwhile read for those ambivalent about treating or waiting.
http://www.clinicaloptions.com/inPractice/Hepatology/Hepatology/ch8_Mgmt_of_Hep_C_Infection/Pages/Page%205/Subpage%206.aspx
Since you have to register I will copy/paste it here.
____________________________________________________
Treat Now or Wait for New Therapy?
Drug development for HCV is progressing extremely rapidly with the discovery of numerous direct-acting antivirals, some of which are in late-stage clinical development with promising early results. Future therapies hold the promise of higher efficacy, shorter duration, and improved tolerability, particularly for regimens that do not require interferon. Unlike first-generation protease inhibitors, many of the new direct-acting antiviral agents or combinations of direct-acting antiviral agents have activity against a broader spectrum of and possibly all HCV genotypes. The prospect of newer therapies raises the issue of whether to treat patients now or wait for the new treatments to arrive.
There are several factors to consider in making the decision to treat vs wait, but ultimately it is an individualized decision that must be made between the physician and patient depending on the specific circumstances of the persons HCV infection. Relevant issues to consider are the severity of liver fibrosis, the probability of sustained virologic response with current therapies, the tolerability of and willingness to accept interferon-based treatment, and the local timeline for approval and reimbursement of new therapies. Additional factors that may also be considered include the age and stage of life of the patient and the presence of extrahepatic manifestations of HCV. Patients with advanced fibrosis who are treatment naive or who have relapsed following peginterferon/ribavirin therapy need treatment and will likely do well with current protease inhibitorbased regimens. By contrast, previous null responders to peginterferon/ribavirin have a low likelihood of response and may benefit from waiting for newer therapies. For patients with genotype 2 or 3 HCV infection, sustained virologic response rates are high with current peginterferon/ribavirin therapy, but all-oral, well-tolerated regimens are currently in phase III development.
Table 7 outlines the authors perspective on which patient groups should probably initiate current therapy, those who should probably wait for future options, and those for whom the decision is less clear, with a list of factors to consider in such cases.
Table 7. Categorization of Patient Groups Suitable for Current Therapy vs Waiting for Newer Therapies
Treat Now
Genotype 1: F3 or F4, treatment naive or previous relapse
Genotype 2-6: F3 or F4, treatment naive
Extrahepatic manifestations of HCV
Wait for New Therapy
Genotype 1: F0-F2 with previous null response
Genotype 2/3: previous relapse or nonresponse
Poor adherence to or tolerability of peginterferon/ribavirin
Relative contraindication to peginterferon/ribavirin
Unclear
F3 or F4 with previous partial or null response
Genotype 1: F0-F2, treatment naive or previous relapse
Genotypes 2-6: F0-F2, treatment naive
Issues to Consider
Severity of liver fibrosis
Previous response to and tolerability of peginterferon/ribavirin
HCV genotype
Age
Comorbidities
Nonmedical factors (eg, patient willingness, family planning, employment)
Local timeline for approval, reimbursement, and availability of newer direct-acting antiviral agents
IL28B genotype (?)
____________________________________________
There's quite a bit more so if interested it might be worthwhile to register.
http://www.clinicaloptions.com/inPractice/Hepatology/Hepatology/ch8_Mgmt_of_Hep_C_Infection/Pages/Page%205/Subpage%206.aspx
Since you have to register I will copy/paste it here.
____________________________________________________
Treat Now or Wait for New Therapy?
Drug development for HCV is progressing extremely rapidly with the discovery of numerous direct-acting antivirals, some of which are in late-stage clinical development with promising early results. Future therapies hold the promise of higher efficacy, shorter duration, and improved tolerability, particularly for regimens that do not require interferon. Unlike first-generation protease inhibitors, many of the new direct-acting antiviral agents or combinations of direct-acting antiviral agents have activity against a broader spectrum of and possibly all HCV genotypes. The prospect of newer therapies raises the issue of whether to treat patients now or wait for the new treatments to arrive.
There are several factors to consider in making the decision to treat vs wait, but ultimately it is an individualized decision that must be made between the physician and patient depending on the specific circumstances of the persons HCV infection. Relevant issues to consider are the severity of liver fibrosis, the probability of sustained virologic response with current therapies, the tolerability of and willingness to accept interferon-based treatment, and the local timeline for approval and reimbursement of new therapies. Additional factors that may also be considered include the age and stage of life of the patient and the presence of extrahepatic manifestations of HCV. Patients with advanced fibrosis who are treatment naive or who have relapsed following peginterferon/ribavirin therapy need treatment and will likely do well with current protease inhibitorbased regimens. By contrast, previous null responders to peginterferon/ribavirin have a low likelihood of response and may benefit from waiting for newer therapies. For patients with genotype 2 or 3 HCV infection, sustained virologic response rates are high with current peginterferon/ribavirin therapy, but all-oral, well-tolerated regimens are currently in phase III development.
Table 7 outlines the authors perspective on which patient groups should probably initiate current therapy, those who should probably wait for future options, and those for whom the decision is less clear, with a list of factors to consider in such cases.
Table 7. Categorization of Patient Groups Suitable for Current Therapy vs Waiting for Newer Therapies
Treat Now
Genotype 1: F3 or F4, treatment naive or previous relapse
Genotype 2-6: F3 or F4, treatment naive
Extrahepatic manifestations of HCV
Wait for New Therapy
Genotype 1: F0-F2 with previous null response
Genotype 2/3: previous relapse or nonresponse
Poor adherence to or tolerability of peginterferon/ribavirin
Relative contraindication to peginterferon/ribavirin
Unclear
F3 or F4 with previous partial or null response
Genotype 1: F0-F2, treatment naive or previous relapse
Genotypes 2-6: F0-F2, treatment naive
Issues to Consider
Severity of liver fibrosis
Previous response to and tolerability of peginterferon/ribavirin
HCV genotype
Age
Comorbidities
Nonmedical factors (eg, patient willingness, family planning, employment)
Local timeline for approval, reimbursement, and availability of newer direct-acting antiviral agents
IL28B genotype (?)
____________________________________________
There's quite a bit more so if interested it might be worthwhile to register.
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http://hepcsupport.org/gileads-single-pill-heptatitis-c-studdy-targets-2014-approval/
i like his blog as well.