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I have yet to see an antispyware/av program that does exactly what it says, and without hickups. A few will do a good job for the most part but will still leave a dangling process or registry entry somewhere, and that may allow for "self-healing" of the malware. Often manual removal is necessary.
Also, I came across a few grbage programs that will download and install other garbage programs while they are being removed in the firstplace. It makes sense to disconnect from the net while cleaning the PC, and then reboot, reboot, and reboot after every scan/cleaning action before reconnecting.
Sometimes it's all a question of time economics; will it be faster to reinstall the OS and all the programs you use, or to clean the PC off the viruses?
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