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why is hepatitis must better treated than Hiv?
Oct 19, 2003

Dr. Young,

I was wondering how some people can be cured when getting treatment for hep c and hep b when hiv cant be cured? Could you explain to me why this is?

Andre

Response from Dr. Young

Andre- thanks for your questions.

Long story short, two different viruses (HBV, HCV), two different treatments and prognosis (for long-term suppresion or "cure").

HBV is like a retrovirus (similar to HIV), and incorporates its genes into the human liver cell chromosome. It can lie dormant there for years, though medications (adefovir, lamivudine or tenofovir) can cause dramatic reductions in the level of virus present. The key difference between HBV and HIV is that with sufficient viral suppression, the human immune system can become "trained" to suppress the virus-- a simplistic way of looking at this is that the meds give the immune system the upper hand, long enough to figure out how to suppress the virus.

HCV does not incorporate its genes and recent advances in therapy can result in long-term durable viral suppression (long after treatment is stopped).

For HIV, there is a very good immune response in many persons that does not result in suppression of virus. This is why so much interest exists around the idea of immune-based strategies. So far, other than treating the acutely infected person, these methods have been dissappointing (to me, anyways). BY



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