Full Movie Viral

[Prometeo Archuleta]

ThePlan provides goal-oriented objectives and strategies that can be implemented by a broad mix of stakeholders at all levels and across many sectors, both public and private, to reverse the rates of viral hepatitis, prevent new infections, improve care and treatment and ultimately eliminate viral hepatitis as a public health threat in the United States. Stakeholders can use these evidence-based objectives and strategies that are most likely to contribute toward achieving national goals to eliminate the public health threat of viral hepatitis.

Viruses are very tiny germs. They are made of genetic material (either DNA or RNA) inside of a protein coating. There are a huge number of viruses on earth. Only a small number of them can infect humans. Those viruses can infect our cells, which may cause disease. Some of the diseases that viruses can cause include the common cold, the flu, COVID-19, and HIV.

Viruses are like hijackers. They invade living, normal cells. They then use those cells to multiply (make copies of themselves). This process is also called replication. The process can kill, damage, or change the infected cells. Sometimes this can make you sick. The symptoms can range from mild to very severe. Other times, your immune system may be able to fight it off and you may not have any symptoms.

For most viral infections, treatments can only help with symptoms while you wait for your immune system to fight off the virus. There are antiviral medicines to treat some viral infections. Antibiotics do not work for viral infections.

Left untreated, hepatitis can lead to cirrhosis, a progressive deterioration and malfunction of the liver. It can also lead to a type of liver cancer called hepatocellular carcinoma. In fact, HBV and HCV infections are related to about 65 percent of liver cancers worldwide. Nearly 50 percent of the cases are caused by HCV alone.2 During the next 40 to 50 years, 1 million people with untreated chronic HCV infection will likely die from complications related to their HCV.3

In an effort to fight viral hepatitis in the United States, the U.S. Department of Health and Human Services developed the National Hepatitis Action Plan for 2017-2020. The plan outlines strategies to achieve the following goals:

Drug and alcohol use places people at particular risk for contracting viral hepatitis. Engaging in risky sexual behavior that often accompanies drug use increases the risk of contracting HBV and, less frequently, HCV. People who inject drugs (PWID) are at high risk for contracting HBV and HCV from shared needles and other drug preparation equipment, which exposes them to bodily fluids from other infected people. Because drug use often impairs judgement, PWID repeatedly engage in these unsafe behaviors, which can increase their risk of contracting viral hepatitis. One study reported that each person who injects drugs infected with HCV is likely to infect about 20 others, and that this rapid transmission of the disease occurs within the first 3 years of initial infection.4 Drug and alcohol use can also directly damage the liver, increasing risk for chronic liver disease and cancer among those infected with hepatitis. This underscores that early detection and treatment of hepatitis infections in PWID and other people who use drugs is paramount to protecting both the health of the person and that of the community.

People with hepatitis who inject drugs often have several other health conditions at the same time, including mental illness and HIV/AIDS, thus requiring care from multiple health care providers. This is sometimes referred to as co-occurring disorders. Substance use disorder treatment is critical for PWID, as it can reduce risky behaviors that increase the chance of transmitting hepatitis. Research has shown that patients with hepatitis receiving medication-assisted treatment for their opioid addiction can be safely treated with antiviral medications.5

Many medications are available for the treatment of chronic HBV and HCV infection. For chronic HBV infection, there are several antiviral drugs. People who are chronically infected with HBV require consistent medical monitoring to ensure that the medications are keeping the virus in check and that the disease is not progressing to liver damage or cancer.

There are also antiviral medications available for HCV treatment and new treatments have been approved in recent years. Many antiviral HCV treatments can cure more than 90 percent of people who take them within 8 to 12 weeks. HCV treatment dramatically reduces deaths, and people who are cured are much less likely to develop cirrhosis or liver cancer. However, not everyone infected with HCV needs or can benefit from treatment. NIDA researchers have identified genes that are associated with spontaneous clearance of HCV. These genes also enable people who are unable to clear HCV on their own to respond more favorably to treatment medications. This new information can be used to determine which patients can benefit most from HCV treatment. More studies must be done, but this is a first step to personalized medicine for the treatment of HCV.

Initial screening for HBV or HCV involves antibody tests, which show whether you have been exposed to the hepatitis virus, although not necessarily whether you are still infected. A positive antibody test should then be followed up with a test that measures the amount of virus in your blood. If this follow-up test is positive, then you should seek advice from a physician that specializes in viral hepatitis treatment. Because screening for hepatitis is so critical for linking people who test positive to the care they need, NIDA is studying new rapid HCV antibody tests that can be used in drug treatment settings.

The CDC recommends that people who inject drugs be tested for hepatitis B and C as part of routine medical care. To determine if you are at risk for contracting hepatitis, HHS has created an online assessment tool to help you find out.

However, ART does not cure HIV. HIV is still in your body when your viral load is suppressed, even when it is undetectable. You need to keep taking your HIV medicine as prescribed. If you skip doses, even now and then, your viral load will quickly go back up, causing your immune cells to drop.

If you have stopped taking your HIV medicine or are having trouble with taking your doses as prescribed, talk to your health care provider as soon as possible about strategies to get your viral load suppressed.

There are important health benefits to having a suppressed or undetectable viral load. People with HIV who know their status, take HIV medicine as prescribed, and get and keep an undetectable viral load can live long and healthy lives.

There is also a major prevention benefit. People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load will not transmit HIV to their HIV-negative partners through sex. This is sometimes called treatment as prevention or undetectable = untransmittable (U=U).

Talk with your health care provider about these benefits of HIV treatment and discuss which HIV medicine is right for you. Stay in medical care and discuss how frequently you should get your viral load tested to make sure you get and keep an undetectable viral load.

Also talk to your provider about ways to prevent other sexually transmitted infections (STls), such as gonorrhea, chlamydia, or syphilis. Having an undetectable viral load only prevents transmission of HIV, not other STls.

The SARS-CoV-2 Interagency Group (SIG), established by the U.S. Department of Health and Human Services (HHS), works to rapidly characterize emerging variants and actively monitors their potential impact on SARS-CoV-2 vaccines, therapeutics, and diagnostics. The SIG is responsible for variant classifications in the United States and meets regularly to evaluate the risk posed by SARS-CoV-2 variants circulating in the United States and globally to make recommendations about the variants. NIAID is a member of the SIG and supports research and surveillance activities to help inform decisions made by the SIG.

The NIAID SAVE program is composed of an international team of scientists with expertise in virology, immunology, vaccinology, structural biology, bioinformatics, viral genetics, and evolution. Researchers from NIAID Intramural, the NIAID Vaccine Research Center, other HHS and Department of Defense laboratories, and the extramural academic community work collaboratively within and across multiple sub-groups to accelerate the pace of variant research and discovery through rapid and open sharing. Researchers are developing high quality data sets that are then vetted by SIG working groups comprised of various experts. These data help inform public health recommendations.

This team is evaluating surveillance/epidemiological data, information from observational studies on the efficacy of COVID-19 vaccines, variant information from documented vaccine breakthrough cases and accompanying sequence data from these efforts to identify variants that should be evaluated further in vitro and in vivo. They will also perform antibody escape mapping in the lab using monoclonal antibodies and polyclonal sera in pseudoviral assays to identify proactively substitutions of concern.

This team characterizes variants identified by the early detection group comprehensively in vitro to determine how they may differ from the original SARS-CoV-2 virus. Variant viruses, pseudoviruses and various convalescent and vaccinee sera samples are used to determine if variants are able to evade infection- or vaccine-induced immunity. Groups are also performing antigenic landscape analyses to determine the relatedness of each emerging variant to the original strain to which vaccines were made. Researchers also analyze characteristics such as in vitro replication kinetics to determine how variant viruses may have different characteristics that affect their ability to replicate or transmit between humans. Groups are also exploring if any variants can evade cellular immune responses generated by memory B-cells and T-cells. The data generated by this groups helps determine which variants are of most concern for our existing countermeasures.

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