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Thoughts about the 2015 Liver Meeting

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Rod

Hi Lucinda Hope you enjoyed the conference.From your comments thru-out it seems you did and found it positive as did I for the most part. I follow the conferences very closely and read through most if not all abstracts and presentations that have to do with the newer treatments especially any info that pertains to the subject of resistance that is seemingly rearing it's ugly head. There is much discussion about and rightfully so about screening patients for "resistance" "Before" prescribing therapy with these new modalitys,however many clinicians ,if not most, are prescribing full steam ahead,given the excellent rates of efficacy with no regard to resistance. This is worrisome to me. As I have mentioned on many occasions this is leaving thousands of patients with long lasting(if not for ever) Resistance mutations that ,for now at least, there is no treatment. I was hoping there would be more discussion about this at the conference. I heard very little about any trials starting inclusive of this subset (other than looking at baseline mutations) I understand perfectly the excitement felt by all. 90-95% efficacy is tremendous,however for clinicians to say to 10 or 15 out of every 100 treated "you have failed treatment and unfortunately the drugs we gave you have caused a long term resistant profile and we don't know how to treat you now" is,as I mentioned very worrisome and quite scary for a rapidly growing number of patients. As we know Lucinda ,in the past if one failed treatment there was the devastating news that you failed,however that was somewhat offset by the news there was no resistance to worry about and you can try again. Today you are told you failed ,you may have a lifetime resistant profile to these class of drugs and we really do not know what to do for you. My hope is that the advocates for HCV patients like your self can be more active in thinking and writing about this ever growing number of folks that for now seem somewhat left behind. Best to you Lucinda Rod

November 21, 2015

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