Herpes Simplex Virus Infections in Immunocompromised Patients
Marie Studahl, Paola Cinque, Tomas Bergström in Herpes Simplex Viruses, 2017
IRD associated to HSV infections has included skin and mucosal lesions, as well as CNS disease. Perianal, genital, or perioral herpes have all been observed (112,113). Cases have been reported of chronic erosive HSV genital infection presenting weeks to months after starting HAART and characterized by florid erosions and copious exudate and, histologically, by plasma cell and eosinophilic infiltrates (114). CNS disease varied in presentation, including temporal lobe encephalitis, encephalomyelitis, or myelopathy, and was often observed in concomitance with mucosal or skin reactivation of HSV (113). In general, the clinical features of immune reconstitution HSV manifestations do not differ from those observed in typical HSV infections and the diagnostic approach is not different. Treatment is based on antiviral drugs. Corticosteroids may be considered in individual cases.
Toward Legitimation: Coping with HIV/AIDS
Desirée Ciambrone in Women's Experiences with HIV/AIDS, 2016
Antiviral drug therapy is central to treating HIV infection and forestalling disease progression. A few women noted that the medication is the most difficult part of their health maintenance regimens. Protease inhibitor regimens or drug "cocktails" are demanding and necessitate planning and strict adherence. As Alicia explained: I gotta take the pills every day. That's the thing that bothered me.... I take like eighteen pills a day. I try to take them as close as possible as I can. Like in the morning—I go to take them in the morning and I don't eat in the morning, but now I gotta have something, like a cracker or a piece a toast to take the pill. And make sure you don't put no butter on that toast, because if you put butter on that toast the fat's gonna [dilute its potency].Robyn said: I get up at 6:00 am and take my pills. Some of them, they're kind of interspersed throughout the day. But the first thing I do is make sure I have taken what I'm supposed to take and then take everything else I need to take during the day so I can get it in my pill container to go to work that day.
Finding a Target
Nathan Keighley in Miraculous Medicines and the Chemistry of Drug Design, 2020
Enzyme inhibitors have been used widely in medicine. To combat infections from microorganisms; shutting down enzymes that are crucial to the function of the bacterial cell will kill the cell or prevent proliferation. It is possible to selectively target bacterial enzymes without effecting our own due to the large biochemical differences between bacteria and ourselves. For example, some of the first antibiotics were the sulphonamides. These acted as competitive inhibitors and medicinal chemists synthesised a library of these compounds to optimise binding interactions to improve efficacy. These drugs were the antibiotics of choice prior to been superseded by penicillin, which also function as competitive enzyme inhibitors, except on a different target. In the fight against viruses, successful antiviral drugs have been developed that work against viral enzymes. Acyclovir for the treatment of herpes and saquinavir for HIV are both enzyme inhibitors. Besides battling against foreign invaders, enzyme inhibitors can be utilized to work against the body’s own enzymes and thus regulate and offer control over the cells biological operations. Anticholinesterases are an example where inhibitors of enzymes were developed for control of problems with the nervous system.
Emerging therapeutics for the management of COVID 19
Published in Expert Opinion on Emerging Drugs, 2020
Sujit Kumar Debnath, Rohit Srivastava, Abdelwahab Omri
In COVID-19, overproduction of IL-6 (an inflammatory cytokine) results in overstimulation of the immune system which leads to serious lungs complications and acute respiratory distress syndrome (ARDS). IL-6 receptor antagonist becomes a promising adjunct therapy to combat COVID-19. The proper monitoring of inflammatory cytokines is highly recommended before administration of anti-IL-6 therapies since the overuse of these drugs may compromise the normal immune defense mechanisms against COVID-19 [177]. Treating with antiviral drugs is a promising approach to cure a viral infection. It is clear that treatment with a single antiviral drug is not sufficient. Antiviral drugs administered in combination with other therapeutic approaches are expected to improve the patient’s outcome. Combination therapy by targeting different pathways will need to explore. Further, drug-drug interactions became a growing concern that can be overcome by systematic review and clinical assessment. Repurposing of existing drugs is the only alternative until the development of novel antiviral drugs or vaccines can be integrated into clinical care. For the time being, a reduction in community transmission is the most reliable method to control virus spread in this pandemic.
Nanomedicine formulations for the delivery of antiviral drugs: a promising solution for the treatment of viral infections
Published in Expert Opinion on Drug Delivery, 2018
David Lembo, Manuela Donalisio, Andrea Civra, Monica Argenziano, Roberta Cavalli
Intriguingly, nanomedicine formulations could represent a new avenue for controlling the amount, dosage frequency, and delivery site of antivirals, as well as for targeting the virus life cycle. Indeed, the features of nanoparticles, such as sizes, morphology and surface charge, can be modulated to promote the targeting of the drugs. Moreover, nanocarriers can be engineered to enhance their ability to reach specific extracellular or intracellular targets and to compete with viruses for attachment to cell surface receptors, both of which are key factors for controlling viral diseases and overcoming drug resistance. Consequently, passive and active drugs targeting are possible with nanomedicine approaches, as previously described for anticancer drugs [6]. Passive targeting depends on the composition and physicochemical characteristics of the nanocarriers; active targeting is based on the presence of a specific ligand on the nanocarrier surface, which acts as a recognition device for viral nanostructures. These drug-targeting strategies might facilitate the local and specific release of antiviral drugs while minimizing damage to healthy cells and tissues, thereby preventing side effects.
A comprehensive review on the antiviral activities of chalcones
Published in Journal of Drug Targeting, 2021
Dana Elkhalifa, Israa Al-Hashimi, Ala-Eddin Al Moustafa, Ashraf Khalil
Managing severe viral infections requires the timely and efficient use of therapeutic antiviral interventions to control the spread of the virus and reduce disease severity. Antiviral medications act principally by targeting either viral or cellular proteins [18]. The first mechanism usually results in a specific targeted response with less side effects, but with a higher possibility for developing drug resistance [18]. The second mechanism on the other hand, while presenting with less chances of developing drug resistance, provides a broad spectrum of antiviral activity and high toxicity profile [18]. Most of the currently approved antiviral drugs function directly or indirectly by targeting different stages of the virus replication cycle as well as specific cellular and viral enzymes required for its replication [19]. These targeted viral life cycle stages involve virus attachment and adsorption, cell fusion, synthesis of viral RNA or DNA and progeny virus release [19]. Since viruses are obligate pathogens that use the host-cell machinery for their replication, finding drug targets that interact with viral replication is challenging [18,19]. Additionally, the current antivirals are associated with a group of limitations which include diminished efficacy, high toxicity, high costs and emergence of drug resistance [18]. Therefore, discovering improved antiviral alternatives targeting viral diseases is highly required, especially with the developing concern of re-emergence of new viral strains and infections.
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