valacyclovir and Influenza--Human

Most viral diseases, with the exception of those caused by human immunodeficiency virus, are self-limited illnesses that do not require specific antiviral therapy. The currently available antiviral drugs target 3 main groups of viruses: herpes, hepatitis, and influenza viruses. With the exception of the antisense molecule fomivirsen, all antiherpes drugs inhibit viral replication by serving as competitive substrates for viral DNA polymerase. Drugs for the treatment of influenza inhibit the ion channel M(2) protein or the enzyme neuraminidase. Combination therapy with Interferon-α and ribavirin remains the backbone treatment for chronic hepatitis C; the addition of serine protease inhibitors improves the treatment outcome of patients infected with hepatitis C virus genotype 1. Chronic hepatitis B can be treated with interferon or a combination of nucleos(t)ide analogues. Notably, almost all the nucleos(t) ide analogues for the treatment of chronic hepatitis B possess anti-human immunodeficiency virus properties, and they inhibit replication of hepatitis B virus by serving as competitive substrates for its DNA polymerase. Some antiviral drugs possess multiple potential clinical applications, such as ribavirin for the treatment of chronic hepatitis C and respiratory syncytial virus and cidofovir for the treatment of cytomegalovirus and other DNA viruses. Drug resistance is an emerging threat to the clinical utility of antiviral drugs. The major mechanisms for drug resistance are mutations in the viral DNA polymerase gene or in genes that encode for the viral kinases required for the activation of certain drugs such as acyclovir and ganciclovir. Widespread antiviral resistance has limited the clinical utility of M(2) inhibitors for the prevention and treatment of influenza infections. This article provides an overview of clinically available antiviral drugs for the primary care physician, with a special focus on pharmacology, clinical uses, and adverse effects.

Topics: Acyclovir; Adenine; Amantadine; Antiviral Agents; Comorbidity; Drug Therapy, Combination; Foscarnet; Ganciclovir; Guanine; Hepatitis; Hepatitis B, Chronic; Hepatitis C; Herpesviridae Infections; HIV Infections; Humans; Influenza, Human; Interferons; Lamivudine; Nucleosides; Oligopeptides; Organophosphonates; Oseltamivir; Proline; Protease Inhibitors; Pyrimidinones; Ribavirin; Telbivudine; Thymidine; Valacyclovir; Valganciclovir; Valine; Virus Replication; Zanamivir

Topics: Adult; Ampicillin; Anti-Bacterial Agents; Antiviral Agents; Coinfection; Herpes Zoster; Humans; Influenza A virus; Influenza, Human; Male; Oseltamivir; Streptococcal Infections; Superinfection; Tonsillitis; Torso; Valacyclovir

Because pregnancy suppresses the immune system, women at any stage of pregnancy are more susceptible to bacterial and viral infection. Pregnant women might thus be at increased risk of complications from pandemic H1N1 virus infection, and illness may progress rapidly.. A 23-year-old primigravida at 9 weeks' gestation was presented to our institution because of the sudden onset of sore throat, fever, chills, and vomiting for 5 days. She was diagnosed with early pregnancy H1N1 infection, vulvar herpes infection, and impending intravascular disseminated coagulopathy. Oseltamivir (Tamiflu) 75 mg and valacyclovir 500 mg were then administered orally twice daily for 5 days. The patient's fever, chills, and vomiting subsided 2 days later. The real-time reverse-transcriptase polymerase chain reaction (RT-PCR) analysis of nasal discharge for influenza virus types A and B showed positive results for the A/H1N1 influenza virus. The early pregnancy was terminated by therapeutic curettage at the patient's request. The surgical specimen revealed products of conception with the presence of necrotic chorionic villi, and focal lymphocytes in decidual tissue. RT-PCR analysis of gestational tissue for A/H1N1 was negative.. Pregnant women with H1N1 infection seem to benefit from antiviral therapy.

Topics: Abortion, Induced; Acyclovir; Adult; Antiviral Agents; Disseminated Intravascular Coagulation; Female; Herpes Genitalis; Humans; Influenza A Virus, H1N1 Subtype; Influenza, Human; Oseltamivir; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, First; Valacyclovir; Valine; Young Adult

Topics: 2-Aminopurine; Acyclovir; Antiviral Agents; Cytomegalovirus Infections; Drug Resistance, Viral; Famciclovir; Guanine; Hepatitis B; Hepatitis C; Herpes Simplex; Herpes Zoster; Humans; Influenza, Human; Valacyclovir; Valine; Virus Diseases

Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Chickenpox Vaccine; Controlled Clinical Trials as Topic; Female; Herpes Genitalis; Herpes Zoster; HIV Infections; Humans; Infant; Influenza Vaccines; Influenza, Human; Male; Public Health; Vaccination; Valacyclovir; Valine

Topics: 2-Aminopurine; Acyclovir; Administration, Oral; Administration, Topical; Amantadine; Animals; Antiviral Agents; Cidofovir; Cytosine; Famciclovir; Foscarnet; Guanine; Herpesviridae Infections; Humans; Influenza, Human; Injections, Intravenous; Lamivudine; Organophosphonates; Organophosphorus Compounds; Rats; Ribavirin; Rimantadine; Thionucleotides; Trifluridine; Valacyclovir; Valine