• Title/Summary/Keyword: Antiviral therapy

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Genotypes of Hepatitis C Virus in Relapsed and Non-respondent Patients and their Response to Anti-Viral Therapy in District Mardan, Khyber Pakhtunkhawa, Pakistan

  • Akhtar, Noreen;Bilal, Muhammad;Rizwan, Muhammad;Khan, Muhammad Asif;Khan, Aurangzeb
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1037-1040
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    • 2015
  • Hepatitis C is a blood-borne infectious disease of liver, caused by a small enveloped, positive-single stranded RNA virus, called the hepatitis C virus (HCV). HCV belongs to the Flaviviridae family and has 6 genotypes and more than 100 subtypes. It is estimated that 185 million people are infected with HCV worldwide and 5% of these are in Pakistan. The study was designed to evaluate different genotypes of HCV circulating in District Mardan and to know about the behavior of these genotypes to different anti-viral regimes. In this study 3,800 patients were exposed to interferon alfa-2a plus Ribavirin treatment for 6-months and subjected to real-time PCR to check the viral response. Among these 3,677 (97%) patients showed no detectable HCV RNA while 123 (3%) patients (non-responders) remained positive for HCV RNA. Genotypes of their analyzed showed that most of them belonged to the 3a genotype. Non-responders (123) and relapsed (5) patients were subjected to PEG-interferon and Ribavirin therapy for next 6 months, which resulted into elimination of HCV RNA from 110 patients. The genotypes of the persisting resistant samples to anti-viral treatment were 3b, 2a, 1a and 1b. Furthermore, viral RNA from 6 patients remained un-typed while 4 patients showed mixed infections. HCV was found more resistant to antiviral therapy in females as compared to mals. The age group 36-45 in both females and males was found most affected by infection. In general 3a is the most prevalent genotype circulating in district Mardan and the best anti-viral therapy is PEG-interferon plus Ribavirin but it is common practice that due to the high cost patients receive interferon alfa-2a plus Ribavirin with consequent resistance in 3% patients given this treatment regime.

A Case of Cytomegalovirus Infection in a Neonate with Osteopetrosis (골화석증에 동반된 거대세포바이러스 감염의 1례)

  • Lee, Sang Hyun;Shin, Jeong Hee;Choi, Byung Min;Kim, Yun-Kyung
    • Pediatric Infection and Vaccine
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    • v.23 no.1
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    • pp.72-76
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    • 2016
  • Infantile osteopetrosis is a rare congenital disorder caused by abnormal bone resorption. Patients with osteopetrosis can have severe anemia, thrombocytopenia, hepatosplenomegaly, rickets, visual impairment, and deafness. Cytomegalovirus also can cause a congenital infection with anemia, thrombocytopenia, hepatosplenomegaly, and calcifications in the brain. We report a 38-day-old infant with severe hepatosplenomegaly, thrombocytopenia, hypocalcemia, and growth failure. Real time polymerase chain reaction detected cytomegalovirus in the plasma. Skeletal radiography revealed generalized bone sclerosis. He was diagnosed with osteopetrosis along with cytomegalovirus infection. Only the test for mutation of the CLCN7 gene, representing the most common and heterogeneous form of osteopetrosis, was available, and the result was negative. With supportive care and antiviral treatment, severe thrombocytopenia due to the cytomegalovirus infection almost normalized despite the possible immunosuppression caused by osteopetrosis. We present the first report of an infant who suffered from osteopetrosis and CMV infection which was successfully treated by long term antiviral agent therapy.

Recurrent Herpes-Stomatitis Mimicking Acute Necrotizing Ulcerative Gingivitis (급성괴사성궤양성 치은염을 닮은 재발성 허피스 구내염)

  • Kim, Han-Seok;Lee, Suk-Keun;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.89-92
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    • 2011
  • Herpes simplex is caused by viruses of the herpesvirus hominus family. HSV have four categories: type 1, 2, 6, and 8. Generally HSV-1 affects the mouth. Once infected by HSV, the person's infection is permanent. Retrograde transport through adjacent neural tissue to sensory ganglia leads to a lifelong latent infection. Recently, we treated a patient with recurrent herpes-stomatitis mimicking acute necrotizing ulcerative gingivitis (ANUG). The results were satisfactorty so we report this case. 31 years old male patient showed sore throat, gingival ulceration, palpable both submandibular lymph node, and sulcular pus formation around posterior decayed teeth. This is the third time he has suffered from this symptom. Tentative diagnosis was acute necrotizing ulcerative gingivitis. Antibiotic therapy was started. But, intraoral symptom got worse in process of time. Especially ulcer of marginal gingiva got worse. Viral disease was suspected. We carried out viral cultivation. At the same time topical application of antiviral ointment (herpecid$^{(R)}$) was performed on oral ulcer unilaterally for the purpose of diagnosis and reducing pain experimentally. The next day pain was decreased dramatically on application area. Basing on the viral cultivation and clinical effect of antiviral ointment (herpecid$^{(R)}$), we have diagnosed it as a recurrent herpes-stomatitis and concluded that viral infection was major cause of disease and bacterial infection was secondary.

A Case of Severe Influenza Infection in a Child with Nephrotic Syndrome on Steroid Therapy (스테로이드 치료중 심한 A형 독감 (H1N1)에 걸린 신증후군 환아 1례)

  • Jung, Su Jin;Park, Sung Eun;Lee, Jun Ho
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.47-50
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    • 2014
  • Infection is the most important cause of death in children with nephrotic syndrome. Influenza viral infections can be fatal for these children, given the annual outbreak of this virus, with the mortality rate being similar to that of respiratory syncytial virus in healthy children. Pneumonia is recognized as the most important complication of influenza infections, as it is associated with high death rates. However, the influenza vaccine, as well as antiviral agents, can be used for prevention and treatment. Therefore, aggressive management with influenza vaccination and antiviral agents will lower the overall mortality rate in children with nephrotic syndrome. Here we report the case of a 7-year-old boy with nephrotic syndrome and influenza A virus (H1N1) pneumonia.

Multifactorial Traits of SARS-CoV-2 Cell Entry Related to Diverse Host Proteases and Proteins

  • You, Jaehwan;Seok, Jong Hyeon;Joo, Myungsoo;Bae, Joon-Yong;Kim, Jin Il;Park, Man-Seong;Kim, Kisoon
    • Biomolecules & Therapeutics
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    • v.29 no.3
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    • pp.249-262
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    • 2021
  • The most effective way to control newly emerging infectious disease, such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, is to strengthen preventative or therapeutic public health strategies before the infection spreads worldwide. However, global health systems remain at the early stages in anticipating effective therapeutics or vaccines to combat the SARS-CoV-2 pandemic. While maintaining social distance is the most crucial metric to avoid spreading the virus, symptomatic therapy given to patients on the clinical manifestations helps save lives. The molecular properties of SARS-CoV-2 infection have been quickly elucidated, paving the way to therapeutics, vaccine development, and other medical interventions. Despite this progress, the detailed biomolecular mechanism of SARS-CoV-2 infection remains elusive. Given virus invasion of cells is a determining factor for virulence, understanding the viral entry process can be a mainstay in controlling newly emerged viruses. Since viral entry is mediated by selective cellular proteases or proteins associated with receptors, identification and functional analysis of these proteins could provide a way to disrupt virus propagation. This review comprehensively discusses cellular machinery necessary for SARS-CoV-2 infection. Understanding multifactorial traits of the virus entry will provide a substantial guide to facilitate antiviral drug development.

Administration of Vitamin C in a Patient with Herpes Zoster - A case report -

  • Byun, Sung-Hye;Jeon, Young-Hoon
    • The Korean Journal of Pain
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    • v.24 no.2
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    • pp.108-111
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    • 2011
  • Herpes zoster as a result of reactivated varicella-zoster virus is characterized by vesicular eruptions on skin and painful neuralgia in the dermatome distribution. Pain during an acute phase of herpes zoster has been associated with a higher risk of developing postherpetic neuralgia. The current therapies for herpes zoster including analgesics and sympathetic nerve block as well as antiviral agents are important to alleviate pain and prevent postherpetic neuralgia. However, in some cases, the pain does not respond well to these treatments. We had a case in which a patient with herpes zoster did not respond to conventional therapy so we attempted to administer intravenous infusion of vitamin C which resulted in an immediate reduction in the pain.

Disseminated Cytomegalovirus Infection and Protein Losing Enteropathy as Presenting Feature of Pediatric Patient with Crohn's Disease

  • Cakir, Murat;Ersoz, Safak;Akbulut, Ulas Emre
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.1
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    • pp.60-65
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    • 2015
  • We report a pediatric patient admitted with abdominal pain, diffuse lower extremity edema and watery diarrhea for two months. Laboratory findings including complete blood count, serum albumin, lipid and immunoglobulin levels were compatible with protein losing enteropathy. Colonoscopic examination revealed diffuse ulcers with smooth raised edge (like "punched out holes") in the colon and terminal ileum. Histopathological examination showed active colitis, ulcerations and inclusion bodies. Immunostaining for cytomegalovirus was positive. Despite supportive management, antiviral therapy, the clinical condition of the patient worsened and developed disseminated cytomegalovirus infection and the patient died. Protein losing enteropathy and disseminated cytomegalovirus infection a presenting of feature in steroid-naive patient with inflammatory bowel disease is very rare. Hypogammaglobulinemia associated with protein losing enteropathy in Crohn's disease may predispose the cytomegalovirus infection in previously healthy children.

Inhibition of HBV replication and gene expression in vitro and in vivo with a single AAV vector delivering two shRNA molecules

  • Li, Zhi;He, Ming-Liang;Yao, Hong;Dong, Qing-Ming;Chen, Yang-Chao;Chan, Chu-Yan;Zheng, Bo-Jian;Yuen, Kwok-Yung;Peng, Ying;Sun, Qiang;Yang, Xiao;Lin, Marie C.;Sung, Joseph J.Y.;Kung, Hsiang-Fu
    • BMB Reports
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    • v.42 no.1
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    • pp.59-64
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    • 2009
  • Hepatitis B virus (HBV) infection is highly prevalent worldwide. The major challenge for current antiviral treatment is the elevated drug resistance that occurs via rapid viral mutagenesis. In this study, we developed AAV vectors to simultaneously deliver two or three shRNAs targeting different HBV-related genes. These vectors showed markedly better antiviral effects than ones that delivered a single shRNA in vitro. A dual shRNA expression vector (AAV-157i/1694i), which simultaneously expressed two shRNAs targeted the S and X genes of HBV, reduced HBsAg, HBeAg and HBV DNA levels by $87{\pm}4$, $80.3{\pm}2.6$ and $86.2{\pm}7%$ respectively, eight days post-transduction. In a mouse model of prophylactic treatment, HBsAg and HBeAg were reduced to undetectable levels and the serum HBV DNA level was reduced by at least 100 fold. These results indicate that AAV-157i/1694i generates potent anti-HBV effects and that the strategy of constructing multi-shRNA expression vectors may lead to enhanced anti-HBV efficacy and overcome the evading mechanism of the virus and thus the development of drug resistance.

Long Term Effects of Lamivudine and Adefovir dipivoxil in Chronic Hepatitis B Patients on the Development of Hepatocellular Carcinoma (만성 B형간질환에서 HBV백신 및 항바이러스치료가 간세포암종 발생에 미치는 효과)

  • Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.1-18
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    • 2008
  • Although Lamivudine and adefovir dipivoxil are efficacious drugs for preventing hepatocellular carcinoma (HCC) in chronic hepatitis B patients, their efficacy is far from completely satisfactory. The risk of liver cirrhosis and HCC begins to increase at an HBV DNA level of $10^4$ copies/ml. Even with latent or past HBV infection, episomal covalently closed circular DNA(cccDNA) plays a key rolein the persistence, relapse and resistance of HBV in its natural course or during therapy. The annual incidence of HCC in YUMC is 1.8% and 4.7% patients/year in the antiviral treatment and control groups, respectively. The ability to achieve a high rate of sustained HBV suppression with low risk of drug resistance is the ultimate goal in the treatment of chronic HBV infection. The efficacy of universal immunization with striking reductions in the prevalence of HBV in localized countries needs to be spread worldwide. With hepatitis B immunization and effective antiviral therapy, global control of HBV infection and HBV-related complications, including HCC, are possible by the end of the first half of the $21^{st}$ century.

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Exacerbation of Sarcoidosis Following Interferon-alpha Therapy for Chronic Active Hepatitis C (만성활동성C형간염에 대한 인터페론 치료 후 사르코이드증의 악화)

  • Chang, Hye Jung;Choi, Eun Hwa;Kim, In Je;Sim, Yun Su;Lee, Jin Hwa;Kim, Tae Hun;Moon, Jin Wook;Chun, Eun Mi;Kim, Yoo Kyung;Sung, Sun Hee;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.285-288
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    • 2006
  • Interferon alpha is an immunomodulator that is used as an antiviral agent to treat chronic active viral hepatitis C. However, interferon can induce or exacerbate sarcoidosis. We report a case of 42-year-old man with an exacerbation of pulmonary sarcoidosis after the cessation of interferon and ribavirin therapy for chronic hepatitis C. The patient's sarcoidosis improved spontaneously and he continues to be monitored regularly without steroid therapy.