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Antiviral Drugs as Tools for Nanomedicine
Published in Devarajan Thangadurai, Saher Islam, Charles Oluwaseun Adetunji, Viral and Antiviral Nanomaterials, 2022
Many researches and clinical trials are studying vaccines for various types of cancers: bladder cancer, brain cancer, breast cancer, cervical cancer, colorectal cancer, kidney cancer, leukemia, lung cancer, melanoma, myeloma, pancreatic cancer and prostrate cancer (Thomas and Prendergast 2016; Lopes et al. 2019; Perez and Palma 2019; Zhang et al. 2020). Treatment of viral diseases include drugs, namely, cidofovir, adefovir dipivoxil, tenofovir, penciclovir, famciclovir, valganciclovir, valaciclovir, ganciclovir, acyclovir, entecavir, tenofovir, lamivudine, adefovir and telbivudine, all of which can help fight the virus but at the same time damage the liver and kidney. The exact frequency of nephrotoxicity induced by these antiviral drugs is difficult to determine. Antiviral drugs cause renal failure through several mechanisms. Direct renal tubular toxicity with unique effects on epithelial cells of the kidney have been reported with use of antiviral drugs (Izzedine et al. 2005). Additionally, crystal deposition in the kidney may promote the development of renal failure. Drug-induced kidney injury is a major side effect in clinical practice, frequently leading to acute renal failure (ARF). It accounts for more than 2% to 15% of cases of ARF in patients admitted to the hospital or in the intensive care unit, respectively (Leowattana 2019).
The roadmap towards cure of chronic hepatitis B virus infection
Published in Journal of the Royal Society of New Zealand, 2022
Although nucleos(t)ide polymerase inhibitors can maintain viral suppression and reduce complications, the need for life-long therapy has several disadvantages. Only a minority of people with chronic HBV Infection are suitable for current treatment – those with significant viraemia and either elevated ALT or significant fibrosis (so-called chronic hepatitis B). For those who commence therapy, there are no widely accepted stopping criteria and treatment is usually lifelong. Despite the availability of generic ETV, TDF and TAF, the cost associated with life-long treatment limits access in low-income countries. Non-adherence will usually result in virologic breakthrough which can lead to severe hepatitis flares and occasionally acute liver failure, emergency transplantation or death. In low income countries, sequential therapy with older therapies (lamivudine, adefovir and telbivudine) may lead to high rates of treatment failure from the emergence of multi-resistant HBV.