In a previous post you made mention of ribavirin not showing efficacy separate from Ifn
correct - rib monotherapy doesn't do much
Do you think efficacy is somehow separate from relapse prevention?
I'm not sure what you are asking. efficacy is largely mediated via prevention of relapse. ribavirin also adds somewhat to virologic response when given with interferon. if you are wondering what is the more important component of the two then i would have to argue - particularly in the era of direct acting agents - that it is inhibition of relapse. mechanistically if the two are related i don't think anyone knows. rib has some activity at the polymerase but most don't think that is it's primary MOA. in short no one really knows how it works (tony seems to be well read on the various immunomodulating roles of the agent but i don't think anyone really knows how this drug acts)
PS: fwiw a year ago many experts thought direct acting agents would supplant ribavirin rather than interferon (at least initially) - i think that iillustrates how speculative predicting future trends are in this area
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