How Can I Be Cured of HCV, But Not HIV?

Question

Are these two viruses that dissimilar? I had HCV, went through the whole interferon thing -48 wks of well, hell; 3 mo post-Tx heptimax showed clearance, as did 6 mo heptimax. HIV is undetectable after initiation of ART. I never missed a single dose of any med, and followed all the rules (empty stomach w/ Atripla, fatty food w/ Ribavirin, etc.) The Dr. says the HIV is "hiding" somewhere in my tissues (brain? spleen? gallbladder? thymus? where is it "hiding"? Everywhere?) Yet, the liver dr. says I'm "cured" of HCV. Well, why isn't the HCV hiding too? Or, conversely, Why am I not cured of HIV? Do these 2 viruses compete in some way? I thought the HIV took over lymphocytes and HCV went after Hepatocytes. My Dr. just looks at me and says "that's the way it is" I know he's right, but I want to know why that is. Thank you!!

Answer

Excellent question. I will have to mention a few words from basic biology to explain.

HCV lives in the cytoplasm of liver cells (hepatocytes).

However, HIV lives in the host cell nucleus and in many different cells of the body. It takes over the host cell machinery.

So since HIV is "integrated" into the nucleus of host cells we can only suppress this virus. In contrast, with HCV we can cure the virus because it is not integrated into the nucleus.

So the basic difference between the two viruses and why HCV can be "cured" and HIV can only be suppressed is due to where they live.

Hope this is helpful to you.