Is there a cure for human herpesvirus 6?
Ganciclovir
Ganciclovir has also been used with some success in treating "Human herpesvirus 6" infections.
Human herpesvirus 6
Researchers have demonstrated that levels of HHV-6 IgG1 and IgM antibodies are elevated in MS patients relative to controls. In fact, research published in 2014 found that increases in anti-HHV-6A/B IgG and IgM titers are predictive of MS relapse.
Human herpesvirus 6
However, one group of researchers ultimately concluded that HHV-6 may not be involved in MTLE related to Mesial Temporal Sclerosis.
Human herpesvirus 6
The extracellular region of CD46 contains four short consensus repeats of about 60 amino acids that fold into a compact beta-barrel domain surrounded by flexible loops. As has been demonstrated for CD46 with other ligands, the CD46 protein structure linearizes upon binding HHV-6. While their precise interaction has not yet been determined, the second and third SCR domains have been demonstrated as required for HHV-6 receptor binding and cellular entry.
Human herpesvirus 6
Researchers consistently report having found HHV-6 DNA in tissues that were removed from patients with MTLE. Studies have demonstrated a tendency for HHV-6 to aggregate in the temporal lobe, with the highest concentrations in astrocytes of the hippocampus.
Roseolovirus
Like the other herpesviruses (Epstein Barr virus, varicella zoster virus, etc.), HHV-6 establishes lifelong latency and can become reactivated later in life. This reactivation has been associated with many clinical manifestations. Reactivation can occur in locations throughout the body, including the brain, lungs, heart, kidney and gastrointestinal tract. In some cases, HHV-6 reactivation in the brain tissue can cause cognitive dysfunction, permanent disability and death.
Pityriasis rosea
Pityriasis rosea is a type of skin rash. Classically, it begins with a single red and slightly scaly area known as a "herald patch". This is then followed, days to weeks later, by a pink whole body rash. It typically lasts less than three months and goes away without treatment. Sometime a fever may occur before the start of the rash or itchiness may be present, but often there are few other symptoms.
While the cause is not entirely clear, it is believed to be related to human herpesvirus 6 (HHV6) or human herpesvirus 7 (HHV7). It does not appear to be contagious. Certain medications may result in a similar rash. Diagnosis is based on the symptoms.
Evidence for specific treatment is limited. About 1.3% of people are affected at some point in time. It most often occurs in those between the ages of 10 and 35. The condition was described at least as early as 1798.
Dharam Ablashi
Dharam V. Ablashi (born October 8, 1931) is an American biomedical researcher born in India. He is best known for his co-discovery of Human herpesvirus 6 (HHV-6), an immunosuppressive and neurotropic virus that can cause encephalitis and seizures during a primary infection or when reactivated from latency in immunosuppressed patients. He has contributed more than 95 papers on HHV-6; most of which appeared in top medical journals and has authored or co-authored over 300 journal articles on herpes viruses. He is internationally known for his research on Human and Simian herpesviruses and has also been a major contributor to research in HIV, Epstein-Barr virus (EBV) and the field of immunovirology.
Human herpesvirus 6
Active infections involve the linear dsDNA genome circularizing by end to end covalent linkages. This process was first reported for the herpes simplex virus. Once circularized, HHV-6 begins to express what are known as "immediate early" genes. These gene products are believed to be transcription activators and may be regulated by the expression of viral micro RNAs. Subsequent expression of "early genes" then occurs and activates, for instance, viral DNA polymerases. Early genes are also involved in the rolling circle replication that follows.
Arenavirus
This virus can be very devastating yet there are very few treatment methods available. The current lack of a licensed vaccine and limited therapeutic options for the Arenavirus make it arguably among the most neglected virus to be dealt with. The only licensed drug for the treatment of human Arenavirus infection is the nucleoside analogue ribavirin. Ribavirin reduces morbidity and mortality in humans who have certain Arenaviruses, such as LASV and JUNV infections, if it is taken in the early stages of the disease. Ribavirin displays mixed success in treating severe Arenaviral disease and is associated with significant toxicities. Effective anti-viral drugs need to be produced at a low cost, taken orally, and able to withstand tropical climates due to the regions where these infections are occurring. For this reason high throughput screening (HTS) of small molecular libraries could be the answer to finding a better remedy. HTS collects libraries of small synthetic molecules that can be used to identify protein promoting “agonist” molecules or protein inhibiting “antagonist” interactions. With HTS sustainable anti-viral drugs can be discovered against possible new human pathogenic viruses.
Human herpesvirus 6
The diameter of an HHV-6 virion is about 2000 Angstroms. The virion's outer portion consists of a lipid bilayer membrane that contains viral glycoproteins and is derived from that of the host. Below this membrane envelope is a tegument which surrounds an icosahedral capsid, composed of 162 capsomeres. The protective capsid of HHV-6 contains double stranded linear DNA.
Cyclin D
In viruses, like Saimiriine herpesvirus 2 ("Herpesvirus saimiri") and Human herpesvirus 8 (HHV-8/Kaposi's sarcoma-associated herpesvirus) cyclin D homologues have acquired new functions in order to manipulate the host cell’s metabolism to the viruses’ benefit.
Viral cyclin D binds human Cdk6 and inhibits Rb by phosphorylating it, resulting in free transcription factors which result in protein transcription that promotes passage through G1 phase of the cell cycle. Other than Rb, viral cyclin D-Cdk6 complex also targets p27, a Cdk inhibitor of cyclin E and A. 
In addition, viral cyclin D-Cdk6 is resistant to Cdk inhibitors, such as p21 and p16 which in human cells inhibits Cdk4 by preventing it from forming an active complex with cyclin D.
Human herpesvirus 6
Epilepsy of the mesial temporal lobe is associated with HHV-6 infection. Within this region of the brain exists three structures: the amygdala, hippocampus, and parahippocampal gyrus. Mesial temporal lobe epilepsy (MTLE) is the most common form of chronic epilepsy and its underlying mechanism is not fully understood.
Genital herpes
Once infected, there is no cure. Antiviral medications, such as acyclovir, valacyclovir, may prevent outbreaks or shorten outbreaks if they occur. The long term use of antivirals may also decrease the risk of further spread. The longer a person has the virus, the less outbreak they experience and the harder it will be to transmit to others, due to these specialty antigens and a strengthened immune system response.
Herpes simplex
Herpes antiviral therapy began in the early 1960s with the experimental use of medications that interfered with viral replication called deoxyribonucleic acid (DNA) inhibitors. The original use was against normally fatal or debilitating illnesses such as adult encephalitis, keratitis, in immunocompromised (transplant) patients, or disseminated herpes zoster. The original compounds used were 5-iodo-2'-deoxyuridine, AKA idoxuridine, IUdR, or(IDU) and 1-β-D-arabinofuranosylcytosine or ara-C, later marketed under the name cytosar or cytarabine. The usage expanded to include topical treatment of herpes simplex, zoster, and varicella. Some trials combined different antivirals with differing results. The introduction of 9-β-D-arabinofuranosyladenine, (ara-A or vidarabine), considerably less toxic than ara-C, in the mid-1970s, heralded the way for the beginning of regular neonatal antiviral treatment. Vidarabine was the first systemically administered antiviral medication with activity against HSV for which therapeutic efficacy outweighed toxicity for the management of life-threatening HSV disease. Intravenous vidarabine was licensed for use by the U.S. Food and Drug Administration in 1977. Other experimental antivirals of that period included: heparin, trifluorothymidine (TFT), Ribivarin, interferon, Virazole, and 5-methoxymethyl-2'-deoxyuridine (MMUdR). The introduction of 9-(2-hydroxyethoxymethyl)guanine, AKA aciclovir, in the late 1970s raised antiviral treatment another notch and led to vidarabine vs. aciclovir trials in the late 1980s. The lower toxicity and ease of administration over vidarabine has led to aciclovir becoming the drug of choice for herpes treatment after it was licensed by the FDA in 1998. Another advantage in the treatment of neonatal herpes included greater reductions in mortality and morbidity with increased dosages, which did not occur when compared with increased dosages of vidarabine. However, aciclovir seems to inhibit antibody response, and newborns on aciclovir antiviral treatment experienced a slower rise in antibody titer than those on vidarabine.
Temporal lobe epilepsy
In the mid 1980s, human herpesvirus 6 (HHV-6) was suggested as a possible causal link between febrile convulsions and mesial temporal lobe epilepsy. However, although the virus is found in temporal lobe tissue at surgery for TLE, it has not been recognised as a major factor in febrile seizures or TLE.
Human herpesvirus 6
Other betaherpesviruses establish latency as a nuclear episome, which is a circular DNA molecule (analogous to plasmids). For HHV-6, latency is believed to occur exclusively through the integration of viral telomeric repeats into human subtelomeric regions. Only one other virus is known to achieve latency in this fashion. This phenomenon is possible as a result of the telomeric repeats found within the direct repeat termini of HHV-6’s genome.
Human herpesvirus 6
Human herpesvirus 6 lives primarily on humans and, while variants of the virus can cause mild to fatal illnesses, can live commensally on its host. It has been demonstrated that HHV-6 fosters the progression of HIV-1 upon coinfection in T cells. HHV-6 upregulates the expression of the primary HIV receptor CD4, thus expanding the range of HIV susceptible cells. Several studies also have shown that HHV-6 infection increases production of inflammatory cytokines that enhance in vitro expression of HIV-1, such as TNF-alpha, IL-1 beta, and IL-8. A more recent in vivo study shows HHV-6A coinfection to dramatically accelerate the progression from HIV to AIDS in pigtailed macaques.
Human herpesvirus 6
HHV-6 has been reported in multiple sclerosis patients and has been implicated as a co-factor in several other diseases, including chronic fatigue syndrome, fibromyalgia, AIDS, optic neuritis, cancer, and temporal lobe epilepsy.
Herpes B virus
Linked with more than two dozen deaths since its discovery, B virus is the only identified nonhuman primate herpesvirus that displays severe pathogenicity in humans. The last identified case of human B virus infection occurred in 2008, with the last known fatality occurring in 1997 when researcher Elizabeth Griffin was splashed in the eye at Yerkes National Primate Research Center. Proper personal protective equipment is essential when working with macaques, especially those animals that have tested positive for the virus. Bites, scratches and exposures to mucous membranes, including the eye, must be cleaned immediately.
Human alphaherpesvirus 3
In 2006, the United States Food and Drug Administration approved Zostavax for the prevention of shingles. Zostavax is a more concentrated formulation of the Varivax vaccine, designed to elicit an immune response in older adults whose immunity to VZV wanes with advancing age. A systematic review by the Cochrane Library shows that Zostavax reduces the incidence of shingles by almost 50%.
Lawrence Corey
• Zerr DM, Meier AS, Selke SS, Frenkel LM, Huang ML, Wald A, Rhoads M, Nguy L, Bornemann R, Morrow RA, Corey L. A population-based study of primary human herpesvirus 6 infection. N Engl J Med. 2005 Feb 24;352(8):768-76.
Human herpesvirus 6
More specific to HHV-6, researchers in 2004 discovered that the initial stages of MS are associated with high levels of the active virus. Soon thereafter, researchers discovered that levels of active HHV-6 are also elevated during relapses/exacerbations of MS.
Herpes simplex research
A study from the Albert Einstein College of Medicine, where glycoprotein D (gD-2) was deleted from the herpes cell, showed positive results when tested in mice. Researchers deleted gD-2 from the herpes virus, which is responsible for herpes microbes entering in and out of cells. The vaccine is still in early stages of development and more research needs to be conducted before receiving FDA approval for clinical trials.
Françoise Barré-Sinoussi
Professor Barré-Sinoussi believes that scientists have made steady progress given the development of antiretroviral treatment which UNAIDS states is being accessed by 17 million of the people globally who are living with AIDS, but finding a cure, or cures, will take time, and a continued investment in research. As the Co-chair of the 21st International AIDS Society (IAS), she said the search for curative strategy of HIV is a goal of paramount importance and a priority for the future of HIV research. Moreover, even though research to achieve such cures is in a formative stage, significant advances are being made towards a HIV cure.
Human herpesvirus 6
Not all newly infected cells begin rolling circle replication. In fact, herpes comes from the Greek word herpein, meaning "to creep." Herpesviruses are 'to creep' in that they may enter a latent stage, inactively infecting their human host. Since its discovery in 1993, this phenomenon has been found among all of the betaherpesviruses.
Central nervous system viral disease
Development of new therapies has been hindered by the lack of appropriate animal model systems for some important viruses and also because of the difficulty in conducting human clinical trials for diseases that are rare. Nonetheless, numerous innovative approaches to antiviral therapy are available including candidate thiazolide and purazinecarboxamide derivatives with potential broad-spectrum antiviral efficacy. New herpes virus drugs include viral helicase-primase and terminase inhibitors. A promising new area of research involves therapies based on enhanced understanding of host antiviral immune responses.
Hepatitis C
Prior to 2012 sustained response occurs in about 40–50% in people with HCV genotype 1 given 48 weeks of treatment. A sustained response is seen in 70–80% of people with HCV genotypes 2 and 3 with 24 weeks of treatment. A sustained response occurs about 65% in those with genotype 4 after 48 weeks of treatment. The evidence for treatment in genotype 6 disease is sparse and what evidence there is supports 48 weeks of treatment at the same doses used for genotype 1 disease.
Human herpesvirus 6
For many, but not all, patients who meet criteria for CFS, the illness begins with an acute, infectious-like syndrome. Cases of CFS can follow well-documented infections with several infectious agents. A study of 259 patients with a "CFS-like" illness published shortly after HHV-6 was discovered used primary lymphocyte cultures to identify people with active replication of HHV-6. Such active replication was found in 70% of the patients vs. 20% of the control subjects (P < 10-8). The question raised but not answered by this study was whether the illness caused subtle immune deficiency that led to reactivation of HHV-6, or whether reactivation of HHV-6 led to the symptoms of the illness.
Human herpesvirus 6
The salivary glands have been described as an in vivo reservoir for HHV-6 infection.
Human herpesvirus 6
The genetic material of HHV-6 is composed of linear (circular during an active infection), double stranded DNA which contains an origin of replication, two 8–10 kb left and right direct repeat termini, and a unique segment that is 143–145kb.
NS5B inhibitor
In 2015, about 71 million individuals throughout the world were living with chronic hepatitis C and there were 1.75 million new hepatitis C virus infections that same year. With highly effective direct-acting antivirals, hepatitis C can be cured within 2-3 months.
Human alphaherpesvirus 3
Human alphaherpesvirus 3, often called varicella-zoster virus (VZV), is one of eight herpesviruses known to infect humans. It causes chickenpox (varicella), a disease most commonly affecting children, teens, and young adults, and shingles (herpes zoster) in adults; shingles is rare in children. VZV is a worldwide pathogen known by many names: chickenpox virus, varicella virus, zoster virus, and Human herpesvirus 3 (HHV-3). VZV infections are species-specific to humans, but can survive in external environments for a few hours, maybe a day or two.
Eliezer (Eli) Huberman
Huberman holds various patents including a series involving 5’-monophoshpate dehydrogenase, a target for the antiviral drug ribavirin, as well as one involving a class of drugs that in vitro are effective against human hepatitis C, immunodeficiency, corona and Ebola viruses.
Genital wart
In the UK, Gardasil replaced Cervarix in September 2012 for reasons unrelated to safety. Cervarix had been used routinely in young females from its introduction in 2008, but was only effective against the high-risk HPV types 16 and 18, neither of which typically causes warts.
There is no cure for HPV. Existing treatments are focused on the removal of visible warts, but these may also regress on their own without any therapy. There is no evidence to suggest that removing visible warts reduces transmission of the underlying HPV infection. As many as 80% of people with HPV will clear the infection within 18 months.
Human herpesvirus 6
During 1986, Syed Zaki Salahuddin, Dharam Ablashi, and Robert Gallo cultivated peripheral blood mononuclear cells from patients with AIDS and lymphoproliferative illnesses. 
Short-lived, large, refractile cells that frequently contained intranuclear and/or intracytoplasmic inclusion bodies were documented. Electron microscopy revealed a novel virus that they named Human B-Lymphotrophic Virus (HBLV).
Oncolytic virus
The first oncolytic virus approved by a national regulatory agency is genetically not modified ECHO-7 strain enterovirus RIGVIR, approved in Latvia in 2004 for treatment of skin melanoma. Later (in 2015 and 2016 respectively) it was also approved in Georgia and Armenia. In 2005 Chinese company, Shanghai Sunway Biotech registered an oncolytic adenovirus, a genetically modified adenovirus named H101. It gained regulatory approval in 2005 from the CFDA, for the treatment of head and neck cancer. The drug talimogene laherparepvec (OncoVex, T-VEC) was the first oncolytic herpes virus (a modified herpes simplex virus), approved for use by the US FDA and by the EMA in the EU in 2015 for the treatment of advanced inoperable melanoma. In a combined decision, members of the FDA's Oncology Drug Advisory Committee and Cellular, Tissue and Gene Therapies Advisory Committee voted 22-1 to recommend approval of the oncolytic immunotherapy.
Human herpesvirus 6
The first study to specifically investigate HHV-6-related demyelination appeared in the literature during 1996, when a previously healthy 19-month-old child developed acute encephalopathy. Levels of myelin basic protein were elevated in his cerebrospinal fluid, suggesting that demyelination was occurring. This link was almost forgotten, until four years later when an MS-related study was published showing an HHV-6 prevalence of 90% among demyelinated brain tissues. In comparison, a mere 13% of disease-free brain tissues possessed the virus.
Betaherpesvirinae
Betaherpesvirinae is a subfamily of viruses in the order Herpesvirales, in the family Herpesviridae. Mammals serve as natural hosts. There are currently 18 species in this subfamily, divided among 4 genera. Diseases associated with this subfamily include: human cytomegalovirus (HHV-5): congenital CMV infection; HHV-6: 'sixth disease' (also known as "roseola infantum" or "exanthem subitum"); HHV-7: symptoms analogous to the 'sixth disease'.
Stephen Straus
Straus is particularly known for his wide-ranging research on herpesviruses that infect humans, including herpes simplex virus (HSV), varicella zoster virus (VZV) and Epstein–Barr virus (EBV). His studies included herpesvirus pathogenesis, immune responses and transmission, as well as antiviral drugs and vaccines.
Human polyomavirus 6
HPyV6 was first discovered in 2010 by rolling circle amplification, a genetic technique that efficiently amplifies and detects circular DNA, such as a polyomavirus genome. It was identified as a component of skin flora in healthy adults, along with Merkel cell polyomavirus (which can cause Merkel cell cancer) and Human polyomavirus 7.
Herpes simplex research
Since the introduction of the nucleoside analogs decades ago, treatment of herpes simplex virus (HSV) infections has not seen much innovation, except for the development of their respective prodrugs (Aciclovir, Famciclovir, Valacilovir..). Drawbacks such as poor bioavailability or limited effectiveness of these drugs require further research effort of new pharmaceutical drugs against the herpes simplex disease. The inhibitors of the Helicase-primase complex of HSV represent a very innovative approach to the treatment of herpesvirus disease.
Hantavirus vaccine
Hantavirus vaccine is a vaccine that protects in humans against hantavirus infections causing Hantavirus hemorrhagic fever with renal syndrome (HFRS) or hantavirus pulmonary syndrome (HPS). The vaccine is considered important as acute hantavirus infections are responsible for significant morbidity and mortality worldwide. It is estimated that about 1.5 million cases and 46,000 death happened in China from 1950 to 2007. The number of cases is estimated at 32,000 in Finland from 2005 to 2010 and 90,000 in Russia from 1996 to 2006.
Herpes simplex
No method eradicates herpes virus from the body, but antiviral medications can reduce the frequency, duration, and severity of outbreaks. Analgesics such as ibuprofen and paracetamol (acetaminophen) can reduce pain and fever. Topical anesthetic treatments such as prilocaine, lidocaine, benzocaine, or tetracaine can also relieve itching and pain.
Bovine herpesvirus 5
Bovine herpesvirus 5 is a virus species of the genus "Varicellovirus" and subfamily Alphaherpesvirinae. It causes meningoencephalitis and respiratory disease in cattle and sheep. As with all herpes viruses latent infection can occur, with recrudescence at times of stressed and/or immunosuppression. Sites of latency include the CNS and mucosae of the nose and trachea. The disease has been documented in South America, the United States, Australia, Germany and Hungary. Caused by: BHV-5 — Bovine Encephalitis Virus — Bovine Encephalitis Herpesvirus
Roseola
Roseola is an infectious disease caused by certain types of virus. Most infections occur before the age of three. Symptoms vary from absent to the classic presentation of a fever of rapid onset followed by a rash. The fever generally lasts for three to five days. The rash is generally pink and lasts for less than three days. Complications may include febrile seizures, with serious complications being rare.
It is caused by either "human herpesvirus 6" (HHV-6) or "human herpesvirus 7" (HHV-7). Spread is usually through the saliva of those who are otherwise healthy. However, it may also spread from the mother to baby during pregnancy. Diagnosis is typically based on symptoms but can be confirmed with blood tests. Low numbers of white blood cells may also be present.
Treatment includes sufficient fluids and medications to treat the fever. Nearly all people are infected at some point in time. Males and females are affected equally often. The disease was first described in 1910 while the causal virus was determined in 1988. The disease may reactivate in those with a weakened immune system and may result in significant health problems.
Human herpesvirus 6
HHV-6’s replication results in the formation of concatemers, which are long molecules that contain several repeats of a DNA sequence. These long concatemers are then cleaved between the pac-1 and pac-2 regions by ribozymes for packaging of the genome into individual virions.
Hepatitis C
Treatment with antiviral medication is recommended in all people with proven chronic hepatitis C who are not at high risk of dying from other causes. People with the highest complication risk should be treated first, with the risk of complications based on the degree of liver scarring. The initial recommended treatment depends on the type of hepatitis C virus, if the person has received previous hepatitis C treatment, and whether or not a person has cirrhosis. Direct-acting antivirals (DAAs) may reduce the number of the infected people.Chronic infection can be cured about 95% of the time with recommended treatment in 2017. Getting access to these treatments however can be expensive. The combination of sofosbuvir, velpatasvir, and voxilaprevir may be used in those who have previously been treated with sofosbuvir or other drugs that inhibit NS5A and were not cured.
Equid alphaherpesvirus 4
Equid alphaherpesvirus 4, formerly Equine herpesvirus 4 (EHV-4) is a virus of the family "Herpesviridae" that cause rhinopneumonitis in horses. It is the most important viral cause of respiratory infection in foals. Like other herpes viruses, EHV-4 causes a lifelong latent infection in affected animals. These horses are usually the source for new infection for foals over two months old, weanlings, and yearlings. Symptoms include fever, loss of appetite, and discharge from the nose. Most infected animals recover in one to three weeks, but death can occur in environments with overcrowding and other stress factors. There are several vaccines available (ATCvet codes: inactivated, live, plus various combinations).
Enterovirus 68
There is no specific treatment and no vaccine, so the illness has to run its course; treatment is directed against symptoms (symptomatic treatment). Most people recover completely; however, some need to be hospitalized, and some have died as a result of the virus.
Five EV68 paralysis cases were unsuccessfully treated with steroids, intravenous immunoglobulin and/or plasma exchange. The treatment had no apparent benefit as no recovery of motor function was seen. A 2015 study suggested the antiviral drug pleconaril may be useful for the treatment of EV-D68.
VZV immune globulin
VZV (varicella zoster virus) globulin or VZV antibodies is an immune system medication that is used mostly for immunosuppressed patients who have been or may be exposed to the varicella zoster virus. It shortens the course of cutaneous disease and may protect against its dissemination. Varicella zoster virus is a human herpes virus that causes chickenpox, shingles, Ramsay Hunt syndrome type II, and postherpetic neuralgia. Unlike a Zoster vaccine which provides durable immunity, the protection is passive and short term; it may need to be readministered every 2-4 weeks as necessary. This medication is not recommended for administration to immune-competent persons for treatment of active disease.
Human herpesvirus 6
Several similar studies followed. A study from October 2014 supported the role of long-term HHV-6 infection with demyelination in progressive neurological diseases.
FI6 (antibody)
FI6 is an antibody that targets a protein found on the surface of all influenza A viruses called hemagglutinin. FI6 is the only known antibody found to bind all 16 subtypes of the influenza A virus hemagglutinin and is hoped to be useful for a universal influenza virus therapy.
Eva Harris
In 2010, Harris entered into a research agreement with NanoViricides, Inc. (NNVC). Under this agreement, Harris and coworkers will evaluate the effectiveness of NanoViricides' drug candidates against various dengue viruses. Cell culture models, as well as in vivo animal studies will be employed for testing the drug candidates. The company believes that a viricidal nanoparticle under development can be expected to lead to a broad-spectrum, anti-dengue antiviral treatment, capable of attacking all four dengue virus serotypes and their variant strains. Currently, there are no approved vaccines for the prevention of dengue, nor are there drugs for treatment of dengue virus infection. The worldwide market size for an effective anti-dengue treatment may be as large as that for Hepatitis C virus treatment, or in the billions of dollars, based on current population exposure data.
Hepatitis C virus
Sofosbuvir for use against chronic hepatitis C infection was approved by the FDA December 6, 2013. It has been reported to be the first drug that has demonstrated safety and efficacy to treat certain types of HCV infection without the need for co-administration of interferon. On November 22, the FDA approved simeprevir for use in combination with peginterferon-alfa and ribavirin. Simeprevir has been approved in Japan for the treatment of chronic hepatitis C infection, genotype 1.
Herpes simplex research
Genocea Biosciences has developed GEN-003, a first-in-class protein subunit T cell-enabled therapeutic vaccine, or immunotherapy, designed to reduce the duration and severity of clinical symptoms associated with moderate-to-severe HSV-2, and to control transmission of the infection. GEN-003 includes the antigens ICP4 and gD2, as well as the proprietary adjuvant Matrix-M. GEN-003 had concluded Phase IIa clinical trials. In December 2015, Genocea announced interim data showing a 58% decrease in viral shedding and a 69% decrease in genital lesions. They also showed one of the doses stopped outbreaks for at least 6 months. GEN-003 was undergoing a Phase IIb clinical trial in the United States. Genocea has announced it would shift their strategic efforts to cancer vaccines while at the same time heavily cutting down on research and development of GEN-003 vaccine against genital herpes. Being unable to secure funding or partnering with another company, Genocea's further vaccine development remains to be determined.
Human herpesvirus 6
In 2012, HHV-6A and HHV-6B were officially recognized as distinct species.
Herpes labialis
Despite no cure or vaccine for the virus, a human body's immune system and specialty antigens typically fight the virus. Docosanol, a saturated fatty alcohol, is a safe and effective topical application that has been approved by the United States Food and Drug Administration for herpes labialis in adults with properly functioning immune systems. It is comparable in effectiveness to prescription topical antiviral agents. Due to its mechanism of action, there is little risk of drug resistance. The duration of symptoms can be shortened a bit if an antiviral, anesthetic, zinc oxide or zinc sulfate cream is applied soon after it starts.
Human herpesvirus 6
Diagnosis for the virus, particularly HHV-6B, is vital for the patient because of the infection’s adverse effects. Symptoms that point to this infection, such as rashes, go unnoticed in patients that receive antibiotics because they can be misinterpreted as a side-effect of the medicine. HHV-6B is known to be associated with the childhood disease roseola infantum, as well as other illnesses caused by the infection. These include hepatitis, febrile convulsions, and encephalitis. Children who suffer from exanthema subitum, caused by an HHV-6B infection, experience fevers lasting 3 to 5 days; rashes on the torso, neck, and face; and sometimes febrile convulsions, however, the symptoms are not always present together. Primary infections in adults are rare since most occurrences are in children. When the infection does occur for the first time in an adult the symptoms can be severe.
Spinocerebellar ataxia type 6
There is currently no cure for SCA 6; however, there are supportive treatments that may be useful in managing symptoms.
Human herpesvirus 6
A variety of tests are used in the detection HHV-6, some of which do not differentiate the two species.
Daniel Peterson (physician)
Peterson is a member of the board of directors and the scientific advisory board of the HHV-6 Foundation, a non-profit organization promoting human herpesvirus 6 (HHV-6) associated scientific and clinical research. Peterson was part of the founding board and is a past-president of the International Association for CFS/ME, a professional organization advocating for the interests of CFS researchers and clinicians worldwide.
Human herpesvirus 6
The unique segment contains seven major core gene blocks (U27-U37, U38-U40, U41-U46, U48-U53, U56-U57, U66EX2-U77, and U81-U82), which is also characteristic of herpesviruses. These conserved genes code for proteins that are involved in replication, cleavage, and packing of the viral genome into a mature virion. Additionally, they code for a number of immunomodulatory proteins. The unique segment also possesses a block of genes (U2-U19) that are conserved among HHV-6, HHV-7, and Cytomegaloviruses (the betaherpesviruses). A number of the unique segment genes are associated with, for instance, the HCMV US22 family. The table below outlines some of their known properties.
Human herpesvirus 6
Humans acquire the virus at an early age, some as early as less than one month of age. HHV-6 primary infections account for up to 20% of infant emergency room visits for fever in the United States and are associated with several more severe complications, such as encephalitis, lymphadenopathy, myocarditis and myelosuppression. The prevalence of the virus in the body increases with age (rates of infection are highest among infant between 6 and 12 months old) and it is hypothesized that this is due to the loss of maternal antibodies in a child that protect him or her from infections.
Betaherpesvirinae
Human cytomegalovirus (HCMV, HHV-5) "seems to have a large impact on immune parameters in later life and may contribute to increased morbidity and eventual mortality." Human herpesvirus 6A (HHV-6A) has been described as more neurovirulent, and as such is more frequently found in patients with neuroinflammatory diseases such as multiple sclerosis. Both human herpesvirus 6B (HHV-6B) and human herpesvirus 7 (HHV-7), as well as other viruses, can cause a skin condition in infants known as exanthema subitum, roseola infantum (rose rash of infants) or the sixth disease.
Human herpesvirus 6
The specific triggers for reactivation are not well understood. Some researchers have suggested that injury, physical or emotional stress, and hormonal imbalances could be involved.
Viral hepatitis
Patients with chronic hepatitis B have antibodies against the virus, but not enough to clear the infected liver cells. The continued production of virus and countervailing antibodies is a likely cause of the immune complex disease seen in these patients. A vaccine is available to prevent infection for life. Hepatitis B infections result in 500,000 to 1,200,000 deaths per year worldwide due to the complications of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Hepatitis B is endemic in a number of (mainly South-East Asian) countries, making cirrhosis and hepatocellular carcinoma big killers. There are six treatment options approved by the U.S. Food and Drug Administration (FDA) available for persons with a chronic hepatitis B infection: alpha-interferon, pegylated interferon, adefovir, entecavir, telbivudine, and lamivudine, with a 65% rate of sustained response.
Human herpesvirus 6
Transmission is believed to occur most frequently through the shedding of viral particles into saliva. Both HHV-6B and HHV-7 are found in human saliva, the former being at a lower frequency. Studies report varying rates of prevalence of HHV-6 in saliva (between 3–90%), and have also described the salivary glands as an in vivo reservoir for HHV-6. The virus infects the salivary glands, establishes latency, and periodically reactivates to spread infection to other hosts.
Galidesivir
Galidesivir (BCX4430, Immucillin-A) is an antiviral drug, an adenosine analog (a type of nucleoside analog). It is developed by BioCryst Pharmaceuticals with funding from NIAID, originally intended as a treatment for hepatitis C, but subsequently developed as a potential treatment for deadly filovirus infections such as Ebola virus disease and Marburg virus disease. It also shows broad-spectrum antiviral effectiveness against a range of other RNA virus families, including bunyaviruses, arenaviruses, paramyxoviruses, coronaviruses, flaviviruses and phleboviruses. BCX4430 has been demonstrated to protect against both Ebola and Marburg viruses in both rodents and monkeys, even when administered up to 48 hours after infection, and development for use in humans is being fast-tracked due to concerns about the lack of treatment options for the 2013-2016 Ebola virus epidemic in West Africa. BCX4430 also showed efficacy against Zika virus in a mouse model, though there are no plans for human trials at this stage.
The Second Angel
It is the late 21st century, when 80% of mankind have been infected with a virus called HPV2 (human parvovirus 2), or P2, whose spread was accelerated with the discovery and use of synthetic blood. P2 disrupts the blood's ability to carry hemoglobin around the body, greatly shortening the host's life. The only known cure for P2 is a complete blood transfusion with healthy blood, coupled with a dose of the drug ProTryptol 14. With only 20 percent of the world's population free of P2, the price of a litre of healthy blood has reached almost two million dollars.
Human herpesvirus 6
During the year 2011, researchers at the National Institutes of Health attempted to elucidate the then unknown method whereby HHV-6a gains entry into the nervous system. As such, they autopsied the brains of around 150 subjects. When various anatomical regions were assayed for their viral load, olfactory tissues were found to have the highest HHV-6 content. They concluded that these tissues are the entry point for HHV-6a.
Human herpesvirus 7
Over 95% of adults have been infected and are immune to HHV-7, and over three quarters of those were infected before the age of six. Primary infection of HHV-7 among children generally occurs between the ages of 2 and 5, which means it occurs after primary infection of HHV-6. A 2014 Washington University School of Medicine's analysis of 102 healthy adults sampled at as many as five major body habitats found that HHV-7 was present in 98% of them, especially in the mouth. A 2017 study looking at the human blood virome in 8,240 humans between the ages of 2 months to 102 years found that 20.37% of them were positive for HHV-7.
Antisense therapy
In early 2006, scientists studying the Ebola hemorrhagic fever virus at USAMRIID announced a 75% recovery rate after infecting four rhesus monkeys and then treating them with an antisense Morpholino drug developed by Sarepta Therapeutics (formerly named AVI BioPharma), a U.S. biotechnology firm. The usual mortality rate for monkeys infected with Ebola virus is 100%. In late 2008, AVI BioPharma successfully filed Investigational New Drug (IND) applications with the FDA for its two lead products for Marburg and Ebola viruses. These drugs, AVI-6002 and AVI-6003 are novel analogs based on AVI's PMO antisense chemistry in which anti-viral potency is enhanced by the addition of positively charged components to the morpholino oligomer chain. Preclinical results of AVI-6002 and AVI-6003 demonstrated reproducible and high rates of survival in non-human primates challenged with a lethal infection of the Ebola and Marburg viruses, respectively.
Human polyomavirus 6
HPyV6 is closely related to HPyV7, which was discovered at the same time; the two viruses' genomes share 68% sequence identity. In the 2015 taxonomic update to the polyomavirus group, the International Committee on Taxonomy of Viruses classified HPyV6 as the type species of the genus "Deltapolyomaviridae". This group contains only four viruses, all of which infect humans: HPyV6, HPyV7, MW polyomavirus, and STL polyomavirus.
Herpes simplex research
Diverse subunit HSV vaccines (e.g. Herpevac) have failed to protect humans from acquiring genital herpes in several clinical trials. The success of the chickenpox vaccine demonstrates that a live and appropriately attenuated α-herpesvirus may be used to safely control human disease. A vaccine of this type would present a slow replication process of HSV, thereby also damping down the immune evasion strategies of the virus while simultaneously exposing the host to the full complement of HSV's majority of viral proteins. As a consequence, it is the intent of the vaccine to expose the individual's immune response to the HSV proteins it may have been missing from a wild type virus in order to effectively control the disease. From a historical retrospective, such live attenuated vaccines have had the most success in preventing diseases until today. Dr. William Halford at the Southern Illinois University (SIU) School of Medicine was testing a live-attenuated HSV-2 ICP0‾ vaccine in 2016, before his death in June, 2017. Already proven as safe and effective in studies on animals, eliciting 10 to 100 times greater protection against genital herpes than a glycoprotein D subunit vaccine, Halford's vaccine has been tested outside of the United States, in St. Kitts and is expecting a 2018 test in Australia.
Herpesviridae
Nine herpesvirus types are known to infect humans: herpes simplex viruses 1 and 2 (HSV-1 and HSV-2, also known as HHV1 and HHV2), varicella-zoster virus (VZV, which may also be called by its ICTV name, HHV-3), Epstein–Barr virus (EBV or HHV-4), human cytomegalovirus (HCMV or HHV-5), human herpesvirus 6A and 6B (HHV-6A and HHV-6B), human herpesvirus 7 (HHV-7), and Kaposi's sarcoma-associated herpesvirus (KSHV, also known as HHV-8). In total, more than 130 herpesviruses are known, some of them from mammals, birds, fish, reptiles, amphibians, and mollusks.
Human herpesvirus 6
As of 2012, this order currently has 3 families, 4 subfamilies (1 unassigned), 18 genera (4 unassigned) and 97 species.
Lymphocystis
There is no known cure for this virus, though a privately owned fish research & breeding facility near Gainesville, Florida USA has reportedly been able to suppress the virus into remission using the human antiviral "Acyclovir" at the rate of 200 mg per 10 US gallons for 2 days. Otherwise, some aquarists recommend surgery to remove the affected area if it is very serious, followed by an antibiotic bath treatment to prevent a secondary bacterial infection of the open wounds.
Cytarabine
When used as an antiviral, cytarabine-5´-triphosphate functions by inhibiting viral DNA synthesis. Cytarabine is able to inhibit herpesvirus and vaccinia virus replication in cells during tissue culture. However, cytarabine treatment was only effective for herpesvirus infection in a murine model.
Human herpesvirus 6
HHV-6 reactivation has also been implicated in the exacerbation of MS via a shift in Th lymphocyte subsets.
Human herpesvirus 6
The virus periodically re-activates from its latent state, with HHV-6 DNA being detectable in 20–25% of healthy adults in the United States. In the immunocompetent setting, these re-activations are often asymptomatic, but in immunosuppressed individuals there can be serious complications. HHV-6 re-activation causes severe disease in transplant recipients and can lead to graft rejection, often in consort with other betaherpesviridae. Likewise in HIV/AIDS, HHV-6 re-activations cause disseminated infections leading to end organ disease and death. Although up to 100% of the population are exposed (seropositive) to HHV-6, most by 3 years of age, there are rare cases of primary infections in adults. In the United States, these have been linked more with HHV-6a, which is thought to be more pathogenic and more neurotropic and has been linked to several central nervous system-related disorders.
Human herpesvirus 6
The human P53 protein functions as a tumor suppressor. Individuals who do not properly produce this protein experience a higher incidence of cancer, a phenomenon known as Li-Fraumeni syndrome. One of HHV-6’s gene products, the U14 protein, binds P53 and incorporates it into virions. Another gene product, the ORF-1 protein, can also bind and inactivate P53. Cells expressing the ORF-1 gene have even been shown to produce fibrosarcomas when injected into mice.
Human herpesvirus 6
Many human oncogenic viruses have been identified. For instance, HHV-8 is linked to Kaposi's sarcoma, the Epstein–Barr virus to Burkitt's lymphoma, and HPV to cervical cancer. In fact, the World Health Organization estimated (2002) that 17.8% of human cancers were caused by infection. The typical methods whereby viruses initiate oncogenesis involve suppressing the host’s immune system, causing inflammation, or altering genes.
Human herpesvirus 6
The results above are consistent with those of previous studies that involved HSV-1 (and a number of other viruses), which also disseminates into the CNS through olfactory tissue.
List of people with hepatitis C
Although HCV was not discovered until April 1989, an estimated 170 million people worldwide are infected by hepatitis C. As of April 2014, 130—150 million globally suffer from chronic hepatitis C infection; a significant number develop cirrhosis of the liver or liver cancer. Each year, 350,000 to 500,000 people die from hepatitis C-related liver diseases. No vaccine is available at this time. The symptoms of infection can be medically managed when the disease is diagnosed early, and a proportion of patients can be cleared of the virus by a course of anti-viral medicines. Globally, an estimated 50–95% of people treated are cured. With more recently developed medications cure rates are around 80 to 95%. The symptoms of HCV infection, especially in its early stages, can be mild enough to conceal the fact of the disease; thus, some people do not seek treatment. As Live Aid founder Bob Geldof states, "Stigma, shame and fear can suffocate awareness. These barriers prevent people from getting tested, receiving treatment, and clearing themselves of this disease". A number of celebrities diagnosed with the disease have decided to go public in order to raise awareness about hepatitis C and to encourage more people to get tested for the disease.
Human herpesvirus 6
Years later, HHV-6 was divided into subtypes. Early research (1992) described two very similar, yet unique variants: HHV-6A and HHV-6B. The distinction was warranted due to unique restriction endonuclease cleavages, monoclonal antibody reactions, and growth patterns.
Human herpesvirus 6
Research suggests that viral infections can be tied even closer to MS. EBV antibodies in healthy individuals remain constant, whereas antibody levels in individuals who later develop MS begin to increase and plateau between 20 and 30 years of age, regardless of age of onset.
Central nervous system viral disease
Characteristics of a viral infection can include pain, swelling, redness, impaired function, fever, drowsiness, confusion and convulsions.Treatments of proven efficacy are currently limited mostly to herpes viruses and human immunodeficiency virus. The herpes virus is of two types: herpes type 1 (HSV-1, or oral herpes) and herpes type 2 (HSV-2, or genital herpes). Although there is no particular cure; there are treatments that can relieve the symptoms. Drugs like Famvir, Zovirax, and Valtrex are among the drugs used, but these medications can only decrease pain and shorten the healing time. They can also decrease the total number of outbreaks in the surrounding. Warm baths also may relive the pain of genital herpes.
Human herpesvirus 6
HHV-6A and HHV-6B were recognized by the International Committee on Taxonomy of Viruses (ICTV) as distinct species in 2012. Human Roseoloviruses include HHV-6A, HHV-6B and HHV-7.
Human herpesvirus 7
Both HHV-6B and HHV-7, as well as other viruses, can cause a skin condition in infants known as exanthema subitum, although HHV-7 causes the disease less frequently than HHV-6B. HHV-7 infection also leads to or is associated with a number of other symptoms, including acute febrile respiratory disease, fever, rash, vomiting, diarrhea, low lymphocyte counts, and febrile seizures, though most often no symptoms present at all.
Human herpesvirus 6
Another product of HHV-6, the immediate early protein U95, has been shown to bind nuclear factor-kappa B. Deregulation of this factor is associated with cancer.
Human herpesvirus 6
During maturation of HHV-6 virions, human cell membranes are used to form viral lipid envelopes (as is characteristic of all enveloped viruses). During this process HHV-6 utilizes lipid rafts, which are membranous microdomains enriched by cholesterol, sphingolipids, and glycosylphosphatidylinositol-anchored proteins. Early researchers suspected that HHV-6 virions mature in the nucleus; some even incorrectly published this, as they generalized and applied to HHV-6 what was known about other viruses. However, researched published in 2009 suggests that the HHV-6 virus utilizes trans-Golgi-network-derived vesicles for assembly.
Genital herpes
Genital herpes is an infection by the herpes simplex virus (HSV) of the genitals. Most people either have no or mild symptoms and thus do not know they are infected. When symptoms do occur, they typically include small blisters that break open to form painful ulcers. Flu-like symptoms, such as fever, aching, or swollen lymph nodes, may also occur. Onset is typically around 4 days after exposure with symptoms lasting up to 4 weeks. Once infected further outbreaks may occur but are generally milder.
The disease is typically spread by direct genital contact with the skin surface or secretions of someone who is infected. This may occur during sex, including anal and oral sex. Sores are not required for transmission to occur. The risk of spread between a couple is about 7.5% over a year. HSV is classified into two types, HSV-1 and HSV-2. While historically mostly cause by HSV-2, genital HSV-1 has become more common in the developed world. Diagnosis may occur by testing lesions using either PCR or viral culture or blood tests for specific antibodies.
Efforts to prevent infection include not having sex, using condoms, and only having sex with someone who is not infected. Once infected, there is no cure. Antiviral medications may, however, prevent outbreaks or shorten outbreaks if they occur. The long term use of antivirals may also decrease the risk of further spread.
In 2015 about 846 million people (12% of the world population), had genital herpes. In the United States, more than one-in-six people have HSV-2. Women are more commonly infected than men. Rates of disease caused by HSV-2 have decreased in the United States between 1990 and 2010. Complications may rarely include aseptic meningitis, an increased risk of HIV/AIDS if exposed to HIV-positive individuals, and spread to the baby during childbirth resulting in neonatal herpes.
Human herpesvirus 6
The molecular mimicry hypothesis, in which T cells are essentially confusing an HHV-6 viral protein with myelin basic protein, first appeared around this time. Early on in the development of this hypothesis (2002), Italian researchers used the HHV-6a variant along with bovine myelin basic protein to generate cross-reactive T cell lines. These were compared to the T cells of individuals with MS as well as those of controls, and no significant difference was found between the two. Their early research suggested that molecular mimicry may not be a mechanism that is involved in MS.
Herpes simplex virus
Herpes simplex virus 1 and 2 (HSV-1 and HSV-2), also known as human herpesvirus 1 and 2 (HHV-1 and HHV-2), are two members of the human "Herpesviridae" family, a set of viruses that produce viral infections in the majority of humans. Both HSV-1 (which produces most cold sores) and HSV-2 (which produces most genital herpes) are very common and contagious. They can be spread when an infected person begins shedding the virus. About 67% of the world population under the age of 50 has HSV-1. In the United States more than one-in-six people have HSV-2. Although it can be transmitted through any intimate contact, it is one of the most common sexually transmitted infections.
Bovine herpesvirus 5
There is currently no treatment or specific vaccine for BHV-5, but BHV-1 vaccines seem to provide some cross-protection.
Human herpesvirus 6
HHV-6A DNA was found in the endometrium of almost half of a group of infertile women, but in none of the fertile control group. Natural killer cells specific for HHV-6A, and high uterine levels of certain cytokines, were also found in the endometrium of the infertile women positive for HHV-6A. The authors suggest that HHV-6A may prove to be an important factor in female infertility.
Hepatitis
In contrast to hepatitis A and B, progression to chronic hepatitis C is much more common. The ultimate goal of hepatitis C treatment is prevention of hepatocellular carcinoma (HCC). The best way to reduce the long-term risk of HCC is to achieve sustained virological response (SVR). SVR is defined as an undetectable viral load at 12 weeks after treatment completion and indicates a cure. Currently available treatments include indirect and direct acting antiviral drugs. The indirect acting antivirals include pegylated interferon (PEG IFN) and ribavirin (RBV), which in combination have historically been the basis of therapy for HCV. Duration of and response to these treatments varies based on genotype. These agents are poorly tolerated but are still used in some resource-poor areas. In high-resource countries, they have been supplanted by direct acting antiviral agents, which first appeared in 2011; these agents target proteins responsible for viral replication and include the following three classes:
These drugs are used in various combinations, sometimes combined with ribavirin, based on the patient's genotype (delineated as genotypes 1-6). Genotype 1 (GT1), which is the most prevalent genotype in the United States and around the world, can now be cured with a direct acting antiviral regimen. First-line therapy for GT1 is a combination of sofosbuvir and ledipasvir (SOF/LDV) for 12 weeks for most patients, including those with advanced fibrosis or cirrhosis. Certain patients with early disease need only 8 weeks of treatment while those with advanced fibrosis or cirrhosis who have not responded to prior treatment require 24 weeks. Cost remains a major factor limiting access to these drugs, particularly in low-resource nations; the cost of the 12-week GT1 regimen (SOF/LDV) has been estimated at US$94,500.
Human herpesvirus 6
HHV-6 has been detected in lymphomas, leukemias, cervical cancers, and brain tumors. Various medulloblastoma cell lines as well as the cells of other brain tumors have been demonstrated to express the CD46 receptor. Viral DNA has also been identified in many other non-pathological brain tissues, but the levels are lower.
Bell's palsy
In some research the herpes simplex virus type 1 (HSV-1) has been identified in a majority of cases diagnosed as Bell's palsy. This has given hope for anti-inflammatory and anti-viral drug therapy (prednisone and acyclovir). Other research, however, identifies HSV-1 in only 31 cases (18 percent), herpes zoster (zoster sine herpete) in 45 cases (26 percent) in a total of 176 cases clinically diagnosed as Bell's Palsy. That infection with herpes simplex virus should play a major role in cases diagnosed as Bell's palsy therefore remains a hypothesis that requires further research.
Telaprevir
On April 28, 2011, the FDA Antiviral Drugs Advisory Committee voted 18–0 to recommend approval telaprevir for people with genotype 1 chronic hepatitis C. The committee reviewed clinical trial data (including findings from the phase-III ADVANCE, ILLUMINATE, and REALIZE studies) showing that combining telaprevir with pegylated interferon and ribavirin produced a higher cure rate—and in less time—than standard therapy alone. This improvement is most notable for hard-to-treat patients including those with HCV genotype 1, people with liver cirrhosis, and those who did not respond to a prior course of interferon-based therapy. Merck's boceprevir, also a new antihepatitis C drug, was given a positive recommendation by the same committee, on the previous day. Telaprevir was fully approved for use in the United States in May 2011.
The hypothesis that host genetics play an essential role in the ability not only to clear acute hepatitis C infection, but also to achieve sustained virologic response (SVR) to interferon-based therapy has been proved with the recent discovery of two single-nucleotide polymorphisms on chromosome 19. Variants in the minor allele rs8099917 and the proximate polymorphism rs12979860, 3 kb upstream of the interleukin (IL)-28B gene, which encodes the endogenous antiviral cytokine IFN-λ, are associated with SVR and with natural viral clearance. The disparate frequencies of these alleles in ethnic groups worldwide may well explain differing rates of SVR among them. The test for one of these polymorphisms is now commercially available and can serve as a powerful predictor of a patient's chance of achieving SVR. Perhaps more importantly, the test can help the clinician personally tailor the duration and even the type of therapy most appropriate for an individual patient, newly or chronically infected with the hepatitis C virus.