Ribavirin or no Ribavirin

[spitzbar]

http://hepatitiscnewdrugs.blogspot.com/2015/03/using-ledipasvirsofosbuvir-in-cirrhotic.html

[Else]

Thank you for posting that!  I have concerns about Ribavirin's side-effects.  Namely, the pruritus.  I had third trimester chloestasis when pregnant with my son 15 years ago.  Bad during day, unbearable at night.  It was unbearable to the point of talking with my doctor about inducing labor early.  No lotion could touch it.  Just grateful that it was winter time - rubbing snow on myself helped a tiny bit.

So when a side-effect says "pruritus", I seriously shudder. 

[Lynn K]

might be a way to argue in favor of Harvoni vs Viekira Pak make sure your doctor knows you have this previous issue.

With Harvoni you should not need Riba but with Viekira Pak it is required for GT 1a's

Good luck

[charly8]

I suspect that the Ribavirin will help reduce the resistance of the virus that may occur when using direct antivirals and probably does not much more. 

This is due to the mechanism of action of the ribavirin.   Ribavirin induces mutations in RNA-dependent replication in RNA viruses. Such hypermutation can be lethal to RNA viruses especially when used with other antivirals.

So basically they way it works is this:

The virus in its natural state is mostly called "wild type" virus.  These wild types are typically very weak strains.  The virus can mutate a resistance to interferon or antivirals but the riba knocks it back down into the wild type again so the the mutations can not get a foothold. 

This is shown in the literature where the 12 week harvoni arms w/o riba had relapsers with NS5A resistance, where the 12 wee harvoni arms with riba did not have NS5A resistance. 

I suspect that 24 weeks of Harvoni is very potent and is superior to 12 weeks of harvoni with riba due to the fact that even the most resistant virus can not hide for 24 weeks from the strong harvoni direct antivirals.