Antiviral Drugs for Viruses Other Than Human Immunodeficiency Virus

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...

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Bibliographic Details
Published in:	Mayo Clinic proceedings Vol. 86; no. 10; pp. 1009 - 1026
Main Author:	Razonable, Raymund R.
Format:	Journal Article
Language:	English
Published:	Rochester, MN Elsevier Inc 01.10.2011 Mayo Foundation Elsevier, Inc Elsevier Limited Mayo Foundation for Medical Education and Research
Subjects:	Acyclovir - analogs & derivatives Acyclovir - pharmacology Acyclovir - therapeutic use Adenine - analogs & derivatives Adenine - pharmacology Adenine - therapeutic use Amantadine - pharmacology Antibiotics. Antiinfectious agents. Antiparasitic agents Antiviral agents Antiviral Agents - pharmacology Antiviral Agents - therapeutic use Biological and medical sciences Comorbidity Diagnosis Drug therapy Drug Therapy, Combination Foscarnet - pharmacology Foscarnet - therapeutic use Ganciclovir - analogs & derivatives Ganciclovir - pharmacology Ganciclovir - therapeutic use General aspects Guanine - analogs & derivatives Guanine - pharmacology Guanine - therapeutic use Health aspects Hepatitis - drug therapy Hepatitis B, Chronic - drug therapy Hepatitis C - drug therapy Hepatitis C - epidemiology Herpesviridae Infections - drug therapy HIV infection HIV Infections - drug therapy HIV Infections - epidemiology Human viral diseases Humans Infectious diseases Influenza, Human - drug therapy Interferons - pharmacology Interferons - therapeutic use Internal Medicine Lamivudine - pharmacology Lamivudine - therapeutic use Medical sciences Nucleosides - pharmacology Nucleosides - therapeutic use Oligopeptides - pharmacology Oligopeptides - therapeutic use Organophosphonates - pharmacology Organophosphonates - therapeutic use Oseltamivir - pharmacology Oseltamivir - therapeutic use Pharmacology. Drug treatments Proline - analogs & derivatives Proline - pharmacology Proline - therapeutic use Protease Inhibitors - therapeutic use Pyrimidinones - pharmacology Pyrimidinones - therapeutic use Ribavirin - pharmacology Ribavirin - therapeutic use Symposium on Antimicrobial Therapy Telbivudine Thymidine - analogs & derivatives Valacyclovir Valganciclovir Valine - analogs & derivatives Valine - pharmacology Valine - therapeutic use Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Virus Replication - drug effects Zanamivir - pharmacology Zanamivir - therapeutic use United States FDA HBeAg ALT HSV mRNA CMV HSV-2 IV SVR SC HSV-1 VZV HIV RSV CSF HHV TK EBV HCV CHB HBV I FN CHC human herpesvirus thymidine kinase hepatitis B virus alanine aminotransferase hepatitis B e antigen herpes simplex virus subcutaneous intravenous cytomegalovirus messenger RNA hepatitis C virus Epstein-Barr virus US Food and Drug Administration sustained virologic response chronic hepatitis B chronic hepatitis C interferon HSV type 2 HSV type 1 cerebrospinal fluid human immunodeficiency virus varicella zoster virus respiratory syncytial virus Infection Virus Medicine Drug Immunopathology Viral disease Retroviridae Antiviral AIDS Human immunodeficiency virus Immune deficiency Lentivirus
ISSN:	0025-6196, 1942-5546, 1942-5546
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Summary:	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.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-General Information-1 content type line 14 ObjectType-Feature-3 ObjectType-Article-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23
ISSN:	0025-6196 1942-5546 1942-5546
DOI:	10.4065/mcp.2011.0309