The Evolution of HIV/AIDS Diagnosis and Treatment

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Questions and Answers

Which of the following is a current challenge in developing antiviral therapies?

  • The need for combination therapies
  • The presence of mutations leading to resistance
  • The lack of animal models for certain viruses (correct)
  • The toxicity of the drugs

How many antiviral therapies are currently available?

  • 85
  • 118 (correct)
  • 33
  • 10

Which viruses are listed as examples of those with no treatment?

  • HIV, Influenza, and Ebola
  • HIV, HCV, and HBV
  • Influenza, Ebola, and HBV (correct)
  • HCV, Influenza, and Ebola

Which of the following is a potential target for antiviral therapy?

<p>Viral replication (D)</p> Signup and view all the answers

What is the primary goal of antiviral therapy?

<p>Target the virus more than the host cell (D)</p> Signup and view all the answers

Which factor(s) can increase the risk of morbidity and mortality in HSV encephalitis?

<p>All of the above (D)</p> Signup and view all the answers

What is the mechanism of action of acyclovir?

<p>Inhibition of viral replication (C)</p> Signup and view all the answers

Which year did Brandon Mercury die of HIV/AIDS?

<p>1991 (D)</p> Signup and view all the answers

What is the profile of HIV/AIDS diagnosis before 1995?

<p>The number of HIV/AIDS diagnoses declined (B)</p> Signup and view all the answers

What is the size of the HIV protease compared to a cellular protease?

<p>HIV protease is smaller than a cellular protease (B)</p> Signup and view all the answers

What is the first protease inhibitor developed for HIV?

<p>Saquinavir (A)</p> Signup and view all the answers

Which drug is 10-100x more potent against CMV compared to acyclovir?

<p>Ganciclovir (B)</p> Signup and view all the answers

What is the mechanism of action of Foscarnet?

<p>Inhibition of viral DNA polymerase (B)</p> Signup and view all the answers

Which drug is a prodrug of acyclovir?

<p>Valacyclovir (D)</p> Signup and view all the answers

What is the most common mechanism of resistance to acyclovir in HSV and VZV?

<p>Downregulation of viral thymidine kinase (B)</p> Signup and view all the answers

Which antiviral drug was found to be superior to placebo in shortening the time to recovery for hospitalized patients with Covid-19?

<p>Remdesivir (D)</p> Signup and view all the answers

What is the viral phase of the Covid-19 infection?

<p>The first weeks when the virus is active (A)</p> Signup and view all the answers

Why is it important to study antiviral drugs?

<p>To treat chronic viral infections (C)</p> Signup and view all the answers

What is the main advantage of vaccines over antiviral drugs?

<p>Vaccines provide long-term immunity (A)</p> Signup and view all the answers

Which virus did Remdesivir originally target?

<p>Ebola (C)</p> Signup and view all the answers

Which antibody therapy was found to be superior to Remdesivir in reducing mortality?

<p>REGN-EB3 (C)</p> Signup and view all the answers

What is the primary translation product of the SARS-CoV2 virus?

<p>Polyprotein (B)</p> Signup and view all the answers

What is the mechanism of action of Remdesivir?

<p>Inhibits viral polymerase (D)</p> Signup and view all the answers

What is the current state of antiviral therapies?

<p>Currently, there are 118 antiviral therapies, with 85 being monotherapies and 33 being combinations. More than 50% of these therapies are for HIV.</p> Signup and view all the answers

What are the challenges in developing antiviral therapies?

<p>The challenges in developing antiviral therapies include shutting down the viral machinery without harming the host cell, dealing with toxicities that are unacceptable (compared to chemotherapy), handling medically-important viruses that cannot be safely propagated or lack a good animal model, addressing mutations that lead to resistance, and preventing the return of viral replication once treatment is stopped.</p> Signup and view all the answers

Why are antiviral therapies important?

<p>Antiviral therapies are important because they can sufficiently suppress or treat a virus, allowing for its clearance or reduction until the immune system can take over. They play a crucial role in managing viral infections and preventing the spread of diseases.</p> Signup and view all the answers

What is the mechanism of action of acyclovir?

<p>Acyclovir gets incorporated into viral DNA and blocks DNA polymerase, causing chain termination.</p> Signup and view all the answers

What are the indications for acyclovir?

<p>Acyclovir is indicated for HSV and VZV infections, and also has in vitro activity against EBV. It is not useful in acute infectious mononucleosis.</p> Signup and view all the answers

How does CMV (Cytomegalovirus) resist the effects of ganciclovir?

<p>CMV can resist the effects of ganciclovir by mutating its phosphotransferase kinase (PK) or DNA polymerase.</p> Signup and view all the answers

What is the mechanism of action of foscarnet?

<p>Foscarnet is an inorganic pyrophosphate analogue that reversibly blocks the pyrophosphate binding site of viral DNA polymerase and inhibits pyrophosphate cleavage from dNTPs.</p> Signup and view all the answers

What is the role of HIV protease in the maturation of the virus?

<p>The HIV protease is responsible for cleaving the edges of the GAG protein, allowing the virus to snap into a mature virion.</p> Signup and view all the answers

What is the significance of the crystal structure of the HIV protease?

<p>The crystal structure of the HIV protease led to the development of drugs that can inhibit its dimerized form, thus preventing viral maturation.</p> Signup and view all the answers

How did the development of protease inhibitors impact HIV/AIDS treatment?

<p>The development of protease inhibitors allowed for the incorporation of combination therapies, leading to a decline in AIDS deaths.</p> Signup and view all the answers

Who were the recipients of the Nobel Prize for the discovery of HIV?

<p>Françoise Barré-Sinoussi and Luc A. Montagnier, two French virologists, were awarded the Nobel Prize for the discovery of HIV.</p> Signup and view all the answers

What is the mechanism of action of Remdesivir?

<p>Remdesivir outcompetes natural nucleotides and gets incorporated into the viral RNA strand, leading to delayed chain-termination and ultimately inhibiting viral replication.</p> Signup and view all the answers

What is the primary translation product of the SARS-CoV2 virus?

<p>The SARS-CoV2 virus produces a large polyprotein through primary translation, which is partly cleaved by the 3CL-protease to produce additional smaller proteins.</p> Signup and view all the answers

Why is it important to study antiviral drugs?

<p>Studying antiviral drugs is important to develop effective treatments against viral infections, prevent the spread of viral diseases, and improve patient outcomes.</p> Signup and view all the answers

What is the advantage of viruses with proofreading capabilities?

<p>Viruses with proofreading capabilities, such as SARS-CoV2, are typically resistant to nucleotide analogues, making it more challenging to develop effective antiviral therapies.</p> Signup and view all the answers

What are some factors that contribute to the importance of studying antiviral drugs?

<p>Viral factors, human factors, and disease factors</p> Signup and view all the answers

Why is Remdesivir not as effective as hoped in the clinical setting?

<p>The mechanism of action is not fully understood</p> Signup and view all the answers

What are some examples of antiviral targets and their corresponding drugs?

<p>Viral attachment (enfuvirtide, palivizumab), cell entry (amantadine), uncoating, transcription (nucleotide analogues), translation, viral assembly, viral release (oseltamivir), integration</p> Signup and view all the answers

What are some challenges in developing antiviral therapies?

<p>Not all viruses have vaccines, chronic viral infections, not everyone is able to mount a response to vaccines, not everyone is able to get a vaccine, breakthrough infections, accessibility</p> Signup and view all the answers

What are the possible targets for antiviral therapy?

<p>Viral attachment, Cell entry, Uncoating, Transcription, Translation, Viral assembly, Viral release</p> Signup and view all the answers

What are the risk factors for morbidity and mortality in HSV encephalitis?

<p>Age &gt;30, Immunocompromised, GCS 8 or less, Delays in receiving acyclovir (&gt;2d)</p> Signup and view all the answers

What is the mechanism of action of acyclovir?

<p>Acyclovir is tri-phosphorylated intracellularly to the active compound ACV-TP. It is initially phosphorylated by viral thymidine kinase and then by cellular kinases. ACV-TP inhibits viral DNA polymerase and results in chain termination.</p> Signup and view all the answers

What is the advantage of acyclovir in antiviral therapy?

<p>Acyclovir has activity only in cells that are infected with the virus and not in uninfected cells.</p> Signup and view all the answers

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