Treatment
The primary objective of HCV therapy is permanent eradication of the virus. The secondary potential benefit of eradication is a reduction in the risk of liver failure and liver cancer. Currently, peginterferon alfa-2a plus ribavirin is the only FDA approved treatment for HIV–HCV co-infected patients. Interferons bind to specific cell surface receptors of virus-infected cells, which induces a complex cascade of protein-protein interactions and a rapid activation of gene transcription. The antiviral effects of interferons are mediated through inhibition of viral penetration or uncoating, inhibiting viral replication or translation of viral proteins, and/or viral assembly and release. The difference between peginterferon and interferon is the addition of a polyethylene glycol (PEG) polymer. The addition of PEG decreases plasma clearance considerably, protects the molecule from proteolytic degradation and reduces its immunogenicity. Peak concentrations are approximately 1.5-2 fold higher than trough concentrations and the half-life is 80 hours (compared to 5.1 hours for interferon alpha-2a). Ribavirin is a synthetic nucleoside analogue, but its mechanism of action is not clearly established. Ribavirin inhibits the replication of a wide range of RNA and DNA viruses. Pharmacokinetics are similar in patients with HIV co-infection compared with HCV mono-infection.
Read more about this topic: Hepatitis C And HIV Co-infection
Famous quotes containing the word treatment:
“I feel that any form of so called psychotherapy is strongly contraindicated for addicts.... The question “Why did you start using narcotics in the first place?” should never be asked. It is quite as irrelevant to treatment as it would be to ask a malarial patient why he went to a malarial area.”
—William Burroughs (b. 1914)
“Judge Ginsburg’s selection should be a model—chosen on merit and not ideology, despite some naysaying, with little advance publicity. Her treatment could begin to overturn a terrible precedent: that is, that the most terrifying sentence among the accomplished in America has become, “Honey—the White House is on the phone.””
—Anna Quindlen (b. 1952)
“Ambivalence reaches the level of schizophrenia in our treatment of violence among the young. Parents do not encourage violence, but neither do they take up arms against the industries which encourage it. Parents hide their eyes from the books and comics, slasher films, videos and lyrics which form the texture of an adolescent culture. While all successful societies have inhibited instinct, ours encourages it. Or at least we profess ourselves powerless to interfere with it.”
—C. John Sommerville (20th century)