Nursing Pharmacology:  Antiviral Drugs

• Antiviral Drugs

  • Anti-viral drugs with activity against HIV (Human Immunodeficiency Virus)

    • "Global HIV/AIDS at the Crossroads:  Where do we go from here?"¹⁸

      Attribution:  "Panelists discuss what progress has been made in fighting this global epidemic, how research findings are being translated into improved clinical outcomes, and how the Bay Area research community is working to address the questions that remain. "Panelists:  Eran Bendavid, Assistant Professor, Medicine, Stanford; Stefano Bertozzi, Dean, School of Public Health, UC Berkeley; Diane Havlir, Professor and Chief of the HIV/AIDS Division & Positive Healthe Program, UCSF; Michael Lairmore, Dean, School of Veterinary Medicine, UC Davis.  "Paul Volberding, AIDS Research Institute and Director of Research, Global Health Sciences, UCSF, moderates Series:  "UC Global Health Institute." University of California Television (UCTV):  Global HIV/AIDS at the Crossroads:  Where do we go from here? https://www.youtube.com/watch?v=II03km_v4C0#t=16 (3/2014) University of California Television (UCTV) YouTube Channel:  https://www.youtube.com/channel/UCh6KFtW4a4Ozr81GI1cxaBQ

       

  • Introduction

  • HIV and AIDS  Etiology

    • "The History of HIV and Current Epidemic"¹⁷

      Attribution:  Gandi M Volberding PA The History of HIV and Current Epidemic https://www.youtube.com/watch?v=ph6_Z6NIx98 (5/2013) University of California Television (UCTV) https://www.youtube.com/channel/UCh6KFtW4a4Ozr81GI1cxaBQ

    • HIV is the viral, etiologic agent of Acquired Immune Deficiency Syndrome (AIDS).² 

      • This virus belongs to a family of human retroviruses (Retroviridae) and is categorized as belonging to the the subfamily of lentiviruses.² 

        • Nononcogenic lentiviruses cause disease in various animal species.

        • Four retroviruses are responsible for human disease and these retroviruses can be subdivided as belonging to two groups:

          • 1. Human T-Cell Lymphotropic Viruses (HTLV-I and HTLV-II).

            • These viruses are transforming retroviruses.

          • 2. Human immunodeficiency viruses (HSV-1 and HIV-2, both causing cytopathologies)

            • HIV-1 virus is most common cause of HIV disease and is characterized by several subtypes exhibiting varied geographic localizations.

            • HIV-2, first recognized in 1986 in West African patients, was originally limited to West Africa.

              • Subsequently, however, this virus can be now identified worldwide. The HIV-1 viral group (M, N, O, P) and HIV-2 group (A-G) are most probably due to distinct transfers to humans from nonhuman primate reservoirs.

                • For example, HIV-1 virus is most likely to have come from chimpanzees and/or gorillas.² 

                  • HIV-1 Transfer to Humans Most Likely Came from Chimpanzees and/or Gorillas²

                    Lersch T Common Chipanzee (Leipzig Zoon) August 2005.9	Fidenci P Gorilla, Congo, September 2008.10

                • By contrast, HIV-2 most likely came from sooty mangabeys.

                  • HIV-2 Transfer to Humans Most likely Came from the Sooty mangabey (Cerocebus atys)² 

                    Sooty mangabey (Cerocebus atys)  Primate Info Net, Library and Information Service, National Primate Research Center, University of Wisconsin, Madison.  Photo Yerkes NPRC.11

          • The AIDS pandemic is mainly due to the HIV-1 M viral group.

            • More restricted epidemics, although occurring in various countries may be due to HIV-1 group O and HIV-2.

    • HIV-1 Molecular Variability²

      • Analysis of HIV isolates shows considerable sequence diversity generally affecting the viral genome.

        • Variability in coding sequences for the viral envelope protein, as an example, ranges from a few percent in isolates from the same infected patient to 50% among isolates from different HIV-1 groups (M,N,O, P, as noted above).²

          • Alterations are localized in "hypervariable regions".

    • Important Molecules in HIV-1

      "Molecules of HIV-1:  What They Look Like and How They Can Be Inhibited"¹³

      Attribution:  Summers M: The molecules of HIV-1:  What they look like and how they can be inhibited.https://www.youtube.com/watch?v=lRW37XBlIqY (4/2011) ThelHMC YouTube Channel:  https://www.youtube.com/channel/UCUOJc_aRBt9eSspTOSklJfw

 

References

Flexner C Antiretroviral Agents and Treatment of HIV Infection, Chapter 59  in Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12th edition (Brunton LL Chabner BA Knollmann BC, eds; Brunton LL, ed; Blumenthal DK  Murri N Hilal-Dandan R, assoc eds, Knollmann BC, consulting ed, on-line edition) The McGraw-Hill Companies, 2011. Fauci AS Lane HC Chapter 189, Human Immunodeficiency Virus Disease:  AIDS and Related Disorders, in Harrison's Online   (Dan L. Longo, Anthony S. Fauci, Dennis L. Kasper, Stephen L. Hauser, J. Larry Jameson, Joseph Loscalzo, Eds.),  Harrison's Principles of Internal Medicine, 18th edition, The McGraw-Hill Companies, Inc. 2012. Longo DL Fauci AS  188, The Human Retroviruses, in Harrison's Online   (Dan L. Longo, Anthony S. Fauci, Dennis L. Kasper, Stephen L. Hauser, J. Larry Jameson, Joseph Loscalzo, Eds.),  Harrison's Principles of Internal Medicine, 18th edition, The McGraw-Hill Companies, Inc. 2012. Safrin S Antiviral Agents, Chapter 49 in Basic & Clinical Pharmacology, 12 e (Katzung BG Masters SB Trevor AJ) The McGraw-Hill Companies, 2012 (on-line edition). Cochrane A Retroviruses Chapter 28 in Fundaments of Molecular Virology, 2e, Acheson NH, ed., John Wiley & Sons pp 342-353 2011. Cochrane A Human Immunodeficiency Virus Chapter 29  in Fundaments of Molecular Virology, 2e, Acheson NH, ed., John Wiley & Sons pp 354-364 2011. Ryan KJ, Ray C. Chapter 18. Retroviruses: Human T-Lymphotropic Virus, Human Immunodeficiency Virus, and Acquired Immunodeficiency Syndrome. In: Ryan KJ, Ray C. eds. Sherris Medical Microbiology (Part editor, Ahmad N Ray CG Drew WL), 5e. New York, NY: McGraw-Hill; 2010. Greene WC Peterlin BM HIV InSite Knowledge Base Chapter:  Published February 2003; content reviewed February 2006. http://hivinsite.ucsf.edu/InSite?page=kb-02-01-01 Lersch T Common Chimpanzee (Leipzig Zoo) 17 August 2005 http://commons.wikimedia.org/wiki/File:Schimpanse_Zoo_Leipzig.jpg Fidenci P Gorilla, Congo, September 2008 http://commons.wikimedia.org/wiki/File:Gorilla_gorilla11.jpg Sooty mangabey (Cerocebus atys) Primate Info Net, Library and Information Service, National Primate Research Center, University of Wisconsin, Madison. Photo:  Yerkes NPRC http://pin.primate.wisc.edu/factsheets/entry/sooty_mangabey Kuiken C Foley B Hahn B Marx P McCutchan F Mellors JW Mullins J Wolinsky S Korber B A compilation and analysis of nucleic acid and amino acid sequences in human Retroviruses and AIDS, Los Alamos, New Mexico:  Theoretic Biology and Biophysics Group, Los Alamos Natinal Laboratory (USgov/DOE, public domain). http://commons.wikimedia.org/wiki/File:HIV-SIV-phylogenetic-tree.svg Summers M: The molecules of HIV-1:  What they look like and how they can be inhibited.  Lecture in the series by ihmc (Florida Institute for Human & Machine Cognition, http://www.ihmc.us/ ); https://www.youtube.com/watch?v=lRW37XBlIqY  Ryan KJ, Ray C. Chapter 7. Pathogenesis of Viral Infection. In: Ryan KJ, Ray C.eds. Sherris Medical Microbiology, 5e. New York, NY: McGraw-Hill; 2010. CDC HTLV-1 and HIV-1 http://commons.wikimedia.org/wiki/File:HTLV-1_and_HIV-1_EM_8241_lores.jpg Chhabra N Oncogenes-Lecture 3, Burkitt's Lymphoma, Figure 4 http://www.namrata.co/oncogenes-lecture-3/ University of California Television (UCTV) (visit:  http://www.uctv.tv/):  The History of HIV and Current Epidemic May 16, 2013 (uploaded) https://www.youtube.com/watch?v=ph6_Z6NIx98 University of California Television (UCTV) (visit:  http://www.uctv.tv/): :  Global HIV/AIDS at the Crossroads:  Where do we go from here? https://www.youtube.com/watch?v=II03km_v4C0#t=16

 

Disclaimer

This Web-based pharmacology and disease-based integrated teaching site is based on reference materials, that are believed reliable and consistent with standards accepted at the time of development. Possibility of human error and on-going research and development in medical sciences do not allow assurance that the information contained herein is in every respect accurate or complete. Users should confirm the information contained herein with other sources. This site should only be considered as a teaching aid for undergraduate and graduate biomedical education and is intended only as a teaching site. Information contained here should not be used for patient management and should not be used as a substitute for consultation with practicing medical professionals. Users of this website should check the product information sheet included in the package of any drug they plan to administer to be certain that the information contained in this site is accurate and that changes have not been made in the recommended dose or in the contraindications for administration.  Advertisements that appear on this site are not reviewed for content accuracy and it is the responsibility of users of this website to make individual assessments concerning this information.  Medical or other information  thus obtained should not be used as a substitute for consultation with practicing medical or scientific or other professionals.