Not ready for DAA's yet?

[pacman]

Well,  i am making the decision to treat today, am Stage I and healthy and convinced, after 7 years of watchful waiting, it is the right time.  My Dr. is recommending Peg/Riba, and wants to reserve DAA's (telepravir/Bocepravir) for Tx failures. the results of SVR for these are good, but he thinks the side effect profile do not warrant them being first line Tx.  Any thoughts out there?

[willy]

Telaprevir is expected to be approved in 6-9 months.

Your chances of clearing are good either way partially due to your low staging.  You will be looking at 48 weeks it would appear of SOC.  It would likely be 24 weeks with Telaprevir.

We still don't know how insurance is going be be for the newer triple therapy drugs.  It would be a shame to wait and then find that your insurance wasn't yet set of for triple therapy, or that their coverage predicated failing SOC first.  I'm not saying that is a possibility, it's just that till we see what insurance will do it is open to speculation.

Many people have difficulty with TX and a percentage have slower recovery from TX post treatment  It may be a deal where triple therapy may be easier due to the duration and recovery time from triple therapy MAY be less due to the shorter treatment time.

The flip side is that triple therapy is going to be more difficult that the 2 drug SOC.  The Telaprevir treatment IS only 12 weeks though followed by 12 weeks of SOC.  Slower responders may have a 36 week SOC course of treatment.

I don't think I've seen much news on it yet, but one final option you don't mention is waiting for approval (you have mild damage) and then start SOC.  IF you are fast responder and net a RVR you continue with SOC.  IF you are a slower responder your doctor could then add Telaprevir without missing a beat.

Any course of treatment in which Telaprevir is prescribed need both the doctor and patience to have a plan A, Plan B, a plan for rash management, a potential plan for rescue drugs, ditto antidepressants/sleep aids/ and an understanding of potential resistance issues which could emerge in a triple therapy TX failure.

The same principles would apply towards Boceprevir when it is approved, but it is associated more with anemia, Telaprevir with rash issues.

There is no wrong answer if this fits your needs now Pac. 
Welcome to the forum.

best,
Willy

[pacman]

Thanks, Willy. That really helps put it into perspective.

[willy]

No problemo.  It's just my opinion.  i think there will be a lot more information in the next 6 months or so. They are still working on the answers to resistance issues.  I may post a link to the latest on that, but after 2 years there were very few...or none resistant virii left, meaning that the resistance issues may only be temporary.  That is a summary, the news there may not be as serious as earlier theorized.

Yet another issue would be if you didn't do well with initial response, whether to wait for Telaprevir, an even better compound, or dual acting anti-viral therapy, of which there are several in the works.

Willy

[Jazzdenova]

Welcome.
What willy said.
I am surprised the Doc isn't waiting till Telaprevir is approved. For 6 to 8 months I would think it would be worth the wait. Considering the less time to treat with a higher success rate.
In the mean time I would try and start as healthy regime as possible, the usual, no drinking, watch your weight- what you eat, exersize, hydrate and stop or curb smoking if possible. If you feel fairly OK going into treatment, my opinion is that you will suffer less during your treatment , though it affects everybody differently.
Good luck with your decision.