Biotech Values

[genisi]

Evolution in the HCV treatment paradigm

If indeed there is different potency in different genotypes as seen in POSITRON trial, ideally we'll have different regimens for them (also for subgroups like naïve, experienced etc), but my guess is there would still be one regimen to start with and a more potent one will follow. One observation that backs this approach is this line from GILD's PR posted by Roy in #msg-81844469:

All patients receiving sofosbuvir/RBV became HCV RNA negative on treatment and relapse accounted for all virologic failures.

So, there was no resistance rather it was lack of full clearance of the virus, and these patients can go on and receive a more potent sofosbuvir containing regimen like you've suggested in #msg-81881061. Perhaps there will be a predictor such as patients on sofosbuvir/RBV not achieving undetectable after 4 weeks, should be given GS-5885 in addition and be dosed for 12 more weeks with full regimen. Perhaps all GT3 patients should get a more potent regimen, but I still think naïve will do better. Will have better understanding with FISSION and FUSION data.