Antiviral treatments

Question 1

Name some common self-limiting viruses

Answer 1

• Rhinovirus
• Parainfluenza
• Adenovirus
• HSV
• VZV
• CMV
• EBV

Question 2

Name the viruses included under the herpesviradae umbrella

Answer 2

Herpesviradae 1: HSV 1

Herpesviradae 2: HSV 2

Herpesviradae 3: VZV

Herpesviradae 4: EBV

Herpesviradae 5: CMV

Herpesviradae 6: HHV6

Herpesviradae 7: HHV7

Herpesviradae 8: HHV8

Question 3

What do HSV 1 and 2 most commonly cause?

Answer 3

Perioral and genital sores

Question 4

What does VZV usually cause?

Answer 4

Chicken pox and shingles

Question 5

Name some physical treatments for HPV/molluscum infections

Answer 5

Chemical, hot and cold treatments which expose the virus to the immune system (e.g cryotherapy)

Often used for localised HPV infections (warts and verrucas)

Question 6

What is interferon alpha used for?

How does it work?

What are the side effects?

Answer 6

Viral hepatitis from chronic HBV and HCV infections by activation of antiviral intracellular and immune responses.

Side effects: flu-like symptoms, fever, loss of appetite, lethargy, depression (2° night fevers → sleep deprivation)

Question 7

In what patient group is hepatitis C the most common in the UK?

Answer 7

Intravenous drug users

Question 8

What can viral hepatitis lead to?

Answer 8

Liver cirrhosis and hepatocellular carcinoma

Also acts as a reservoir of infection that can be transmitted on

Question 9

How are chronic HBV and HCV treated?

Answer 9

PEG-IFN-alpha for 48 weeks +/- other drugs

Question 10

What can be given to a newborn of a woman with chronic hepatisis B to prevent transmission?

Answer 10

Immunoglobulin & hep B vaccine

Question 11

What are the symptoms of ramsay hunt syndrome?

How can you differentiate from Bell’s palsy?

Answer 11

Unilateral facial nerve palsy

Loss of taste sensation over anterior 2/3 of tongue (ipsilateral)

Vesicles in ear and mouth present in Ramsay Hunt but not in Bell’s palsy

Question 12

Describe the mechanism of action of aciclovir

Answer 12

Aciclovir is converted to is triphosphate form (aciclovir triphosphate- ACV-TP) which competitively inhibits viral DNA polymerase, incorporates into and terminates the growing viral DNA chain and inactivates the viral DNA polymerase.

Question 13

Which anti-viral drugs are used for influenza?

Answer 13

Oseltamivir (tamiflu)

Question 14

Where does HCV replicate?

What are the implications for this?

Answer 14

In the cytoplasm- is therefore easier to treat

Question 15

Which anti-viral drugs can be used for HIV infection?

(on the drugs list)

Answer 15

Nucleoside reverse transcriptase inhibitors:

• Tenofivir

Non-nucleoside reverse transcriptase inhibitors:

• Efavirenz

Viral protease inhbitors:

• Lopinavir

Integrase inhibitors:

• Dolutegravir

Viral fusion inhibitors:

• Enfuvirtide

Chemokine receptor/CCR5 antagonists:

• Maraviroc