Exam 4 - Stahelin Hep B and C (study)

Question 1

Describe the Hep B and C virus life cycles. What steps are targeted by anti-HCV and anti-HBV drugs?

Answer 1

step 4: NS3/NS4A serine protease inhibitors (simeprevir, boceprevir, and telaprevir) act on polyprotein
step 5:

Question 2

Ribavirin (HCV)
MOA:
MOR:
SOA:

Answer 2

MOA:
-inhibits inosine monphosphate dehydrogenase which reduces GTP levels
-direct inhibition of viral RNA polymerase
-incorporation into viral RNA
MOR: N/A
Indication: Hep C (in combo with interferon)

Question 3

grazoprevir (HCV)
MOA:
MOR:
SOA:

Answer 3

MOA:
MOR:
SOA:

Question 4

voxilaprevir (HCV)
MOA:
MOR:
SOA:

Answer 4

MOA:
MOR:
SOA:

Question 5

glecaprevir (HCV)
MOA:
MOR:
SOA:

Answer 5

MOA:
MOR:
SOA:

Question 6

sofosbuvir (HCV)
MOA:
MOR:
SOA:

Answer 6

MOA:
-NS5B inhibitor = HCV RNA polymerase inhibitor
-incorporated into viral RNA chain, causing chain termination
MOR: single mutation in active site (S288T)
SOA:

Question 7

ledipasvir (HCV)
MOA:
MOR:
SOA:

Answer 7

MOA:
MOR:
SOA:

Question 8

elbasvir (HCV)
MOA:
MOR:
SOA:

Answer 8

MOA:
MOR:
SOA:

Question 9

dasabuvir (HCV)
MOA:
MOR:
SOA:

Answer 9

MOA: RNA polymerase shaped like hand with palm, fingers and thumb. Binds to palm site to prevent conformational changes and block nucleotide incorporation into viral RNA
MOR: N/A
SOA:

Question 10

daclatasvir (HCV)
MOA:
MOR:
SOA:

Answer 10

MOA:
MOR:
SOA:

Question 11

velpatasvir (HCV)
MOA:
MOR:
SOA:

Answer 11

MOA:
MOR:
SOA:

Question 12

pibrentasvir (HCV)
MOA:
MOR:
SOA:

Answer 12

MOA:
MOR:
SOA:

Question 13

lamivudine (HBV)
MOA:
MOR:
SOA:

Answer 13

MOA:
MOR:
SOA:

Question 14

entecavir (HBV)
MOA:
MOR:
SOA:

Answer 14

MOA:
MOR:
SOA:

Question 15

tenofovir (HBV)
MOA:
MOR:
SOA:

Answer 15

MOA:
MOR:
SOA:

Question 16

Describe the interactions of HCV protease inhibitors with CYP P450s

Question 17

Describe the proposed MOA of ribavirin. What viruses are susceptible to it?

Question 18

Explain the basics of how HBV reactivation may occur during treatment of HCV in patients with previous history of HBV.