Dewo,
Given that RVR is a good indication of SVR and that Rib significantly increases SVR, I would think adding Rib to interferon also increases RVR. If thats the case, then you would think Rib should play a role in early viral kinetics. However, I can't find data to support that hypothesis.
I disagree with you that lambda is a more potent agent than alpha in terms of "direct" anti viral activity. If you look into IL-29's patent, Zymo compared interferon induced genes (ISG) activation between lambda and alpha with micro array and found that IL-29 is much weaker in ISG activation. Therefore, I am more inclined to the idea that the potency of lambda is due to its immunomodulatory role rather than direct anti viral activities. I know you would argue the micro array data is based on transformed hepatocytes and hcv liver cells might express more IL-29R, but maybe Clark might be right that lambda can have the same immunomodulatory role as Rib and can therefore work the same magic to suppress relapse.
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