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Re: Update..
Oct 15, 2002
The major difference between the two pegs is that the Pegasys has a much better profile in clinical trials of repairing damage to the liver. There have been documented reversal of damage with the Pegasys. That is a very significant difference, indeed. This is most likely due to the fact that the Pegasys is metabolized in the liver itself, while the peg-intron used the kidneys. It is the size of the molecule that makes this the case. The manufacturer of peg-intron has worked really hard to seed the notion that there is little difference. This is a big difference.

Reducing the viral load does not repair damage to the liver. It may, or it may not, arrest progression when progression has been demonstrated. The guidelines for treatment recommend treatment for those with stage 3 damage or greater. Below that, the damage is not considered to be worrisome.

Each person is different. However, the studies show fairly consistently that once treated, if the treatment is not successful, future treatments are compromised.

In the absence of mitigating factors, wthose with little or no damage to the liver whould wait to see whether there will be progression of disease before treating with interferons. The major culprits to damage are more likely to be alcohol and smoking, rather than viral action, but viral action is something that needs close scrutiny before ruling it out entirely, Fortunately, there is time to do that because progression does move slowly, when it occurs at all.

For a genotype 2, the non-detect rate is about 76% with Pegasys. Also a great improvement over the peg-intron. Couple that with the potential to resolve the damage, and it is a really good option for those with damaged livers.

The jury is still out on what viral load reduction actually means in terms of end of treatment response. Surely it would be a good thing if the risks were minimal. Each person has to make a cost/benefit analysis (with their provider) to come up with an answer that makes sense for their own situation.


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