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dewophile

02/18/12 7:56 PM

#137347 RE: oc631 #137309

i could be way off here but i'm not sure if anyone really knows what proportion of nulls are resistant to ribavirin specifically. if you think about it they are all resistant to interferon, which as monotherapy produces decent drop in VL which they don't achieve. conversely many could be responsive to ribavirin since functional ribavirin monotherapy (given interferon resistance) is not expected to produce material drop in VL. in fact, this is what i think vrus/gild were banking on when moving forward with rib/7977 arm in nulls. apparently we now learned that many nulls are in fact resistant to ribavirin - or else how do you explain the difference (even in these small numbers) between the treatment naive and null populations in the 7977 study

by the way i bet a good number of relapsers are less sensitive to ribavirin since one of the primary effect of ribavirin seems to be in preventing relapse (through a poorly defined MOA)