Where does the virus go and why ?

[Sheltonmj]

After talking to my doctor I am confused.
 After the havoni stops the virus from replicating how and why does it reside in our body.
 Does it change form?
 If it's not replicating does it die?
  Isn't in general a fact that a virus is the smallest known living to man?
 Also all virus's need a piece of a molecule to replicate and this is what causes the virus to live and replicate?
 Is this why we become reinfected? Possibly.
 And does harvoni attach itself to a molecule and alter it?

[Sheltonmj]

Dumb question. Sorry.

[gnatcatcher]

No, not dumb questions. The reason I didn't answer is that I have no idea how it all works. I was hoping someone who understands all this stuff would post an explanation in simple, clear English.

[byebyeC]

Harvoni contains two direct-acting antiviral drugs that target different steps of the hepatitis C virus (HCV) lifecycle. Sofosbuvir is a nucleotide analogue HCV polymerase inhibitor, meaning it blocks the polymerase enzyme which the virus must use to reproduce. Ledipasvir is an HCV NS5A replication complex inhibitor that interferes with another protein HCV uses to reproduce.

That's the scientific explanation. I read on another post, can't quite place where, that one of the drugs attach to the "legs" of the virus, basically putting an impenetrable sock on them so they can't attach to the liver's cells. They have to do this to replicate. The hcv does die within the body. That's why we get differing viral loads at different times before tx. Otherwise numbers would only increase. Not go up and down pre-tx as they do. The other drug interferes with the specific protein hcv needs to replicate, so it's a one two punch. Stuff's in the pike to make it a one, two, three punch. Harvoni is working very well as long as patients are getting it for a long enough tx duration.

[gnatcatcher]

Thanks, byebyeC -- your explanation helped me a lot, especially the socks and legs analogy.

[Bree]

Yes, I read that too in a post somewhere...I'm thinking that it renders the virus lame (so to speak) and unable to replicate.  Also, it can't attach to replicate and it dies.  Brilliant breakthrough as far as I'm concerned!  I'm assuming that it flushes out of the body through waste... hence, the drinking of a lot of water helps flush out dead virus... and then it's byebyeC (pun intended, had to say that byebyec;).

[byebyeC]

Precisely! 

[KimInTheForest]

Here is a link to an article from July that I found useful in explaining how the cure works: "How Sure is a Cure"

http://www.hepmag.com/articles/relapse_risk_2502_27511.shtml

From the article:

"Unlike HIV, HCV does not weave its way into the genetic material of the cells it infects. Hep C occupies the cell’s cytoplasm rather than its nucleus, making it more accessible to antiviral therapies than HIV. Also, while HIV hides out in unreplicating cells, sometimes for years, leaving the virus safe from the assault of antiretroviral treatment, HCV must replicate in cells. DAAs attack hep C by interfering with various points in its lifecycle within a cell, halting replication and contributing to its ultimate demise. … It is believed that the immune system itself is responsible for clearing away the last of the virus."

This may not have been your original question, Shelton. But for many of us, the question on our minds is "how can we be sure that every last strand of HCV is gone, and the virus hasn't just gone into a dormant state, waiting to resume replication when it is safe again?"

Well, it turns out HCV can't do that (although other chronic viruses like HIV and HBV can). HCV only has one state of activity in your cells: replication.

Also, you asked (right in your title) where does the virus go. The dead virus slaughtered during the massacre of treatment is eliminated through the bowel. So it is important to keep yourself regular and keep your bowels working properly while on treatment. Staying well hydrated helps with that.

best,
kim

[gnatcatcher]

Thanks, Kim -- very helpful. And thanks, Sheltonmj, for starting this thread.

I'll probably need to re-read the article excerpt over and over before it sinks in. I've joked that perhaps I've acquired so many diagnoses over the years in order to give me more chances to learn biology (my nemesis as far as my high school GPA was concerned).

Gnatty

[Sheltonmj]

Thank you very much.
 I now understand it's much more complicated
 And it leaves us in such a fitting way.
Shelton.
 

[gnatcatcher]

. . . And it leaves us in such a fitting way.
Shelton.
 

Well put!

[Scoutdoy]

Thanks to all of you. I really wanted to know about how this really works and it's a relief, because now I actually think I "get it" it was tough though...ahhhh just kidding. But I was questioning in my mind why is this so much different than HIV and I get it now


Scout

[tblount]

This is my basic understanding...

Although viruses can't reproduce outside their host they are essentially a parasite.  The evolution of parasites requires they attain a balance of self survival through reproduction vs killing their host from reproducing so fast they kill their host.  Hep c must be easily killed by our immune system because I probably have had it about 40+ years. 

Eventually our immune systems get weaker with age and the virus reproduces billions of particles a day that our system, especially the liver, can't cope with. If not treated in a way to slow it down we have to get a liver transplant or die from liver failure.

This new drug has a way to sneak into the viruses reproduction system without detection and replace a key molecule with a dud that cause the reproduction process to fail.  Eventually even a weak immune system will kill off the old virus.

[Else]

The dead virus slaughtered during the massacre of treatment...

Nice visual, Kim!  I think I'm seeing another treatment warrior.  So far here I've met Beatrix Kiddo and Frodo.  I'm tempted to start a "who's your most influential warrior" thread.   

[KimInTheForest]

Nice visual, Kim!  I think I'm seeing another treatment warrior.  So far here I've met Beatrix Kiddo and Frodo.  I'm tempted to start a "who's your most influential warrior" thread.   

Great idea, Else! Go for it.

kim