What to do? Two new drugs on the market (or virtually there) and much said of each.What hard facts do we know at this point and what is conjecture?

School of thought number one holds that Teleprevir (marketed as Incivik)  seems to be the more successful. This is based somewhat on the use of Pegasys versus Pegintron(pegylated Interferon). Both test regimens include Ribavirin (Rebitrol) as well. The protocol is three doses a day every eight hours. To say this is brutal on the body is probably the most understated part of the regimen. In order for the body to survive this assault, it’s necessary to keep eating, to include fats and other nutrients while faced with nausea, emesis and general malaise. Trying to keep food down seems to be a major project from talking with my neighbor who did this. Anemia is one of the primary problems as well.

Steve, who had (has?) Genotype 1A, had previously done the cure and SVR attainment evaporated six months later. He tells me he was counseled on the poorer showing of Teleprevir when used a second time after a failed course of the Pegintron/Ribavirin for 44 weeks back in 2009. Nevertheless, he’s SVR today and alive. I say alive in a guarded tone. He compared it to “being drug backwards through a knothole”. I was hospitalized in 09 when he did this and only found out around Christmas 2009.

The newer Vertex treatment was paid for in full by his employer’s medical which must be exorbitant. Steve said he had long discussions with his sig. other about going through this again. He’s not a Veteran so this has no bearing on the vA financing it. Documented results from the trials show a greatly improved (up from 50% to as high as 80%)  success rate for first time candidates and 66% for second or third time do overs.  He’s still SVR as we speak so he will be entered in the books as a member of those 66% unless or until he isn’t SVR again.

School of thought number two is  the Boceprivir(marketed as Victrelis) regimen. While it is showing decidedly poorer percentages, this may be in part due to the use of Peginton/Ribavirin rather than the newer Pegasys/Ribavirin protocol.  Here’s the difference:

Pegasys 

Pegintron

To my way of thinking, they are both rat poison. The stuff almost killed me because I’m autoimmune. Worse, the doctor knew it and proceeded apace.

Although there is a marked difference in the two drugs, as a layperson I cannot delineate the two. The mere fact that the rate of cure for genotype 1A and 1B has gone up dramatically is reason for hope. Before, the SVR response rate on the original cocktail of Pegintron/Ribavirin was 33-40%. It was a high as 80% for genotype 2A, 2B and the 3A ,3B subgroups. Apparently, the new protocol is not recommended for them. I’m unsure why but it is immaterial to this. Suffice it to say it’s a non-starter for a cure. As a side note, my vA ARNP, Eileen, was all atwitter about this and how I should seriously entertain it. She must not read my medrecs because I’m not a candidate (AIH and genotype 3A).

Steve tells me he could discern little difference between the two programs. He said he was equally sick on both. He lost weight, became anemic and extremely depressed. He resorted to smoking  left-handed Marlboros in an effort to keep his appetite  stimulated and the nausea down to a dull roar. Of course, that doesn’t explain why he feels the need to continue this medication plan afterwards. What do I know? As the vA is fond of reminding me, I have no medical training. I was the rocket scientist in Laos who reasoned that if the insect repellent they gave you worked well on the skin ( it didn’t in Monsoon) then it should be a no brainer if you brushed your teeth with it.

Of the two to three dozen who who have related their failed IFN horror stories, I see one common thread. In spite of predictions of “some discomfort and a flu-like feeling” after doses, most have had far worse. The absolute worst cases that failed have included the oft-repeated tale of cognitive dysfunction (brain fog), onset of DM2, and even rare cases of cancers. These are just a few of the many side effects.

Granted, these new regimens are modeled around three eight hour applications of the drug rather than a nuclear strike of once to three times a week in huge doses.  Medical science always starts out with an aggressive, 1,000 lb. bomb policy and ratchets back when the test subjects start falling like flies. In the early days, this stuff was so insidious that many had to bail out after a short period due to the inability to hack the course. Their medical complications far exceeded the day to day debilities associated with chronic HCV. I had to quit after one dose due to the autoimmune factor. Others would do well to observe this danger, too.

The new regimen is not for everyone. Talking it over with your doctor is not the only thing you should do. Read and Google the internet for as much as you can find. You are going to subject yourself to a mind and body-altering substance that may not be the panacea that you anticipate. Science is not static on this subject. We have recently seen new drugs and studies on the market such as these I describe here which may indeed prove successful. Condemning yourself to any one therapy may be risky beyond a safe parameter.

Check some of these out:

New drugs for Hep. C

Boceprevir in untreated HCV 

Boceprevir trial results 

There are many more on the net. Put aside the Big Pharma/Big Brother/ Big money To Be Made when you view these. We’re talking about your health. There is no such thing as spending too much to stay alive. I’m a poster child for that but not because of the Rat poison. I cringe to think what I cost the vA for a year at the Seattle VAMC and four operations. Those costs were born entirely by American taxpayers.  I apologize to you. It was the Doogie Howser brigade in Seattle.

With this knowledge in hand, perhaps some of you can educate yourselves and decide what is best for you rather than become swept up in this cattle drive rush to the Interferon trough. Now that I have graduated to Stage 4 and cirrhosis, my abiding hope is for a cure that is not more debilitating than the disease. I envision a drug that will envelope the virus and neutralize or encapsulate it. HCV is so remarkably successful at surviving for one reason. It mutates so frequently into a slightly different animal that your body cannot respond and destroy it quickly enough. Putting a ziploc baggie around every one is the ticket. When we figure out how to do it, we’ll be the masters of the universe. Cancer should be a piece of cake after this.

Please do not take this to be the begin all or end all of the discussion about this subject.   I know many come here looking for a thumbs up or down as to whether to embark on the therapy. I have no druthers on it. I can’t do it myself. I know others who have with no success. My neighbor conquered it (or so we hope) with the newer program but he is just one of a new test cohort. My gut feeling is that the jury is still out. In the interim, to stay alive is paramount.

Over the years, I have had occasion to observe new products in the building industry. I am not one for being the guinea pig on these things and usually sit them out until they are proven bulletproof. In more cases than not, I was proven right. Let’s hope a newer, less obnoxious way of killing this bug and making it extinct will come to pass. It will piss me off if it happens a week after I punch out, though.