Direct antiviral agents (DAAs) - A new age in the treatment of hepatitis C virus infection
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Keywords:
Hepatitis C
Viral Hepatitis
Antiviral drug
Antiviral Therapy
Combination therapy
Long-term antiviral therapy is the standard treatment for acquired immune deficiency syndrome,chronic hepatitis B,and chronic hepatitis C.Meanwhile,increasing risk of drug resistance has become the biggest challenge in long-term antiviral therapy.More and more antiviral drug resistances have emerged in treatment experienced patients at present.But there are only a few of limited choices among antiviral agents.Furthermore,the existence of cross-resistance limits the use of the alternative antiviral agents.Under this circumstance,it is important to minimize the risks and hazards of drug resistance by making full use of the characteristics of drug resistance,such as decreased replication capacity and virulence of drug-resistant strains,testing the mutants and adjusting the treatment regime as soon as possible.
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The current status of antiviral therapy is reviewed, including discussion of older approaches together with more recently developed chemotherapy. Following the introduction dealing with pathophysiological aspects of virus disease, the different approaches to antiviral therapy are presented. The reasons for the slow progress in antiviral therapy are discussed. These include: 1. the necessity of intracellular penetration of drugs acting on viral replication; 2. the severe toxicity of most antiviral drugs; 3. the narrow antiviral spectrum of most of these agents; 4. the difficulty of making a rapid etiological diagnosis in view of the necessity of starting (specific?) treatment early in the course of the disease; 5. the difficult evaluation of beneficial as compared with deleterious effects of antiviral therapy. After a detailed review of clinically tested substances, including immunoglobulins, synthetic antiviral drugs (amantadine, nucleoside analogs, thiosemicarbazones and photodynamic dyes) and interferon, a guide concerning indications and application of specific antiviral therapy is presented. Although at present there are few indications, clinicians should be aware of the (present and future) possibilities of antiviral therapy.
Antiviral Therapy
Amantadine
Antiviral drug
Broad spectrum
Antiviral Treatment
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Antiviral drug
Antiviral Therapy
Nucleoside analogue
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Chronic hepatitis B is a preventable and treatable disease basically treated by antiviral therapy.Nucleos(t)ide analogs have shown great potential as first line antiviral drugs.However,drug resistance should be concerned during antiviral therapy.Furthermore,drugs with high effect and low resistance have high priority in clinical practice and the therapeutic maneuver should be depended on the change of the disease.
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In the past decade, the treatment of chronic Hepatitis B (CHB) has been revolutionized by the increased availability of effective antiviral agents. However, there is an alarming of the increasing rates of viral resistance and suboptimal response in CHB patients with single drug therapy. Recently, the strategy of combination therapy for CHB has been proposed and concerned by clinicians. In this review, using PubMed and web of science as main searching tools, we evaluated various latest research reports on combination therapy for CHB, and made a summary of the progress of combination antiviral therapy and outline areas that need to be addressed in the future.
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In the treatment of chronic hepatitis B (CHB) patients with drug resistance, rescue combination therapy leads to viral suppression in almost all patients. However, once it is achieved, lifelong maintenance especially, by using combination therapy is not always possible in a significant proportion of patients. At present, there is no consensus on whether it is possible to switch to monotherapy from combination therapy. However, there is robust evidence to support step-down therapy, which involves switching from combination therapy to monotherapy in antiviral resistant CHB patients who achieve complete viral response from combination therapy. We review the evidence in favor of switching to monotherapy in antiviral resistant CHB patients who achieve complete viral response by combination therapy.
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Rescue therapy
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Hepatitis B
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The purpose of the study.Evaluation of antiviral therapy (OEM ) in children with CHC. Materials and Methods.In 26 patients with CHC aged 3-17 years held HTP pegylated long-acting ( Peginterferon -alfa2b for 60 mcg/m2 per week.)And Rebetol ( ribavirin 15 mg / kg per day) .Duration of therapy ranged from 24 ( genotype 2.3 ) to 48 (in patients with genotype 1) weeks.Results.In assessing the effectiveness of combination antiviral therapy found that sustained virologic response occurred in 78,6 ± 11,0%% of patients with genotype 1, and 83,3 ± 10,8% with genotype 2.3. Conclusion.The results suggest that the combination of peginterferon ribovirin is effective in treating children with CHC.
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Pegylated interferon
Viral Hepatitis
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Antiviral therapy is the key therapy of chronic hepatitis B.Effective antiviral drugs for hepatitis B virus include interferon and nucleotide analogues.Single medication therapy can gain good effect and it is easy to monitor and manage.Combination therapy can not increase the efficiency and avoid the occurrence of resistance.Combination therapy maybe results in multi-resistance,increases adverse effects and expenses of therapy.Therefore single medication therapy is better.
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In this article are presented the results of comparative observation of the effectiveness of the inclusion in the complex therapy of 203 hospitalized children aged 2 years and older with influenza А(Н1N1)pdm09 domestic antiviral drug — Umifenovir (Arbidol) that occurred during the epidemic seasons 2009—2013 and 2015—2016 in terms of observational clinical studies. It is shown that this drug, possessing a wide spectrum of antiviral activity, including against Oseltamivir — and Zanamivir-resistant influenza virus strains, antioxidant activity and low toxicity (Code ATX Ј05АХ13), can be successfully used in the treatment of infants with influenza А(Н1N1)pdm09.
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Oseltamivir
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This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: We aim to assess the relative effectiveness and safety of competing oral antiviral drugs (ACV, FCV and VCV) prescribed to suppress recurrent genital herpes. In other words, we aim to assess the three possible pair‐wise comparisons of each antiviral drug against each other. In addition, we aim to assess whether the effectiveness depends on drug doses and regimen.
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Regimen
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Sex organ
Valaciclovir
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