Podcast
Questions and Answers
What is one of the main goals of HAART?
What is one of the main goals of HAART?
Under what circumstances should ART be initiated, regardless of CD4 count?
Under what circumstances should ART be initiated, regardless of CD4 count?
Which of the following antiviral medications inhibits DNA polymerase by competing with Guanosine triphosphate?
Which of the following antiviral medications inhibits DNA polymerase by competing with Guanosine triphosphate?
What is the main mechanism of action for interferons?
What is the main mechanism of action for interferons?
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What is a common use for Oseltamivir?
What is a common use for Oseltamivir?
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What is a significant challenge in developing antiviral drugs?
What is a significant challenge in developing antiviral drugs?
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Which enzyme is specifically targeted by antiviral drugs for viral replication?
Which enzyme is specifically targeted by antiviral drugs for viral replication?
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What is a primary function of the Neuraminidase inhibitors used in influenza treatment?
What is a primary function of the Neuraminidase inhibitors used in influenza treatment?
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What combination is typically seen in HAART for HIV infections?
What combination is typically seen in HAART for HIV infections?
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Why does combination therapy usually work better for HIV compared to monotherapy?
Why does combination therapy usually work better for HIV compared to monotherapy?
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Which of the following is an example of a chemokine receptor antagonist used in HIV treatment?
Which of the following is an example of a chemokine receptor antagonist used in HIV treatment?
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What does the term 'obligate intracellular parasite' refer to in the context of viruses?
What does the term 'obligate intracellular parasite' refer to in the context of viruses?
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Which of the following best describes the function of integrase in viral replication?
Which of the following best describes the function of integrase in viral replication?
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Study Notes
Antiviral Drugs
- Antiviral drugs target viral enzymes or structures crucial for replication.
- These drugs are available for viruses causing significant morbidity and mortality.
- Developing antiviral drugs is challenging as they need to inhibit viral replication without harming host cells.
Overview of Viral Infections
- Common viral infections include encephalitis/meningitis (JC virus, measles, LCM virus, arbovirus, rabies), pharyngitis (adenovirus, Epstein-Barr virus, cytomegalovirus), cardiovascular (Coxsackie B virus, Hepatitis A, B, C, D, E), skin infections (varicella-zoster virus, HHV-6, smallpox, molluscum contagiosum, HPV, parvovirus B19, rubella, measles, Coxsackie A virus).
- Additional categories include Sexually transmitted diseases (Herpes simplex type 2, HPV, HIV), Eye infections (Herpes simplex virus, adenovirus, cytomegalovirus), Parotitis (Mumps), Pneumonia (influenza virus, types A and B, parainfluenza virus, respiratory syncytial virus, adenovirus, SARS CoV), Myelitis (Poliovirus, HTLV-I), Gastroenteritis (adenovirus, rotavirus, norovirus, astrovirus, coronavirus), and Pancreatitis (Coxsackie B virus).
Learning Objectives
- Factors hindering antiviral drug development
- Specific targets for antiviral drugs, particularly against Herpes viruses
- HAART (highly active antiretroviral therapy) in HIV infections
- Advantages of combination therapies in HIV treatment over monotherapy
- Neuraminidase inhibitors for influenza infections
- Interferon therapy for hepatitis C
Problems in Developing Antiviral Agents
- Selectivity: Viruses have unique structures, and mutations can change antigen proteins.
- Toxicity: Viruses rely on host cell functions for infection, reproduction, and release. Effective antiviral agents must inhibit the virus without being harmful to the host's cells.
Targets for Antiviral Agents
- Structures/enzymes crucial for viral replication (DNA-dependent DNA polymerase, RNA-dependent RNA polymerase, RNA-dependent DNA polymerase, Integrase, Protease, Neuraminidase)
- Key steps in Viral Replication (Attachment & Penetration of virus into host cell, Uncoating of virus, Synthesis of new viral components by host cell, Assembly of components into new virus, release of virus from host cell)
HIV Virus structure
- gp120 (docking glycoprotein)
- gp41 (transmembrane glycoprotein)
- RNA
- Capsid
- Matrix
- Lipid Membrane
Antiretroviral drugs (ART)
- Nucleoside reverse transcriptase inhibitors (Zidovudine)
- Non-nucleoside reverse transcriptase inhibitors (Nevirapine)
- Protease inhibitors (Indinavir)
- Integrase inhibitors (Raltegravir)
- Chemokine receptor antagonists (Maraviroc)
- HIV fusion inhibitor (Enfuvirtide)
HAART (Highly Active Antiretroviral Therapy)
- The standard HIV treatment involves a combination of at least three drugs (2 NRTIs, 1 or 2 Pls).
- Goals of HAART include:
- Suppressing HIV viral load (<50 copies/mL).
- Reducing viral resistance.
- Restoring/preserving immune function (CD4 count >200 cells/mm³).
- Reducing mortality and morbidity rates among HIV infected individuals.
- Improving quality of life.
- Preventing HIV transmission
HAART (WHO Guidelines)
- Initiate ART if CD4 cell count is ≤500 cells/mL for individuals with severe/advanced HIV disease, or CD4 count is ≤350 cells/cu mm, or with active TB, HBV co-infection (with severe chronic liver disease), pregnant and breastfeeding women.
Herpes Simplex Viruses (HSV)
- HSV-1: Oral herpes
- HSV-2: Genital herpes
Antiviral Therapy for Herpes Viruses
- Acyclovir, Famciclovir: These drugs compete with guanosine triphosphate to inhibit DNA polymerase.
- Uses: Herpes simplex and varicella-zoster infections
Anti Influenza drugs
- Neuraminidase inhibitors (Influenza A&B): Oseltamivir, Zanamivir
- Amantadine and Rimantadine (used only in Influenza A): Inhibit uncoating & assembly of influenza A virus.
Interferons
- Types: α, β, γ
- Mechanism: Inhibits viral replication (preventing viral penetration, assembly/release, translate viral mRNA into viral proteins).
- Uses: Chronic hepatitis B & C.
- PegIFNα-2a & 2b are superior to conventional IFN.
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Description
Test your knowledge on antiviral medications, including HAART and its goals. This quiz covers the initiation of ART regardless of CD4 count, the mechanism of action of interferons, and the use of specific antiviral drugs like Oseltamivir. Evaluate your understanding of these crucial topics in the field of medicine.
