Abstract

Publisher Summary This chapter discusses the advances in chemotherapy against DNA and RNA viruses. Special emphasis is given on retrovirus inhibitors. Several researches on anti-virals along with a number of a more medical bias are going on. The research in this area has concentrated mainly on the herpes family of viruses. Most research has targeted either herpes simplex virus type 1 (HSV 1) or type 2 (HSV 2). Many nucleoside analogues that are active against HSV 1 or HSV 2 share a common mode of action. In that, they require activation to the monophosphate by the viral specified thymidine base (TK). The corresponding triphosphates, derived from these monophosphates, then inhibit the viral DNA polymerase. Acyclovir (ACV) continues to be the only treatment for genital herpes infections. The oral formulation of ACV is effective against both primary and recurrent genital herpes, with minimal side effects, but the rate of recurrence returns to pretreatment frequencies once ACV is discontinued. Recent research suggests that oral ACV is safe and effective when taken continuously for up to a year. Topical ACV, while effective against primary herpes infections, is not efficacious when used for recurrent disease. This lack of efficacy may be because of the fact that in topical formulations ACV poorly penetrates human skin. Intravenous ACV, which is superior to vidarabine for herpes encephalitis, is currently being tested clinically for neonatal herpes. Resistance has not been an important clinical problem. The in vitro activity of dihydroxyphenylglycine (DHPG) is comparable to ACV; the enhanced in vivo activity is attributed to the persistence of DHPG triphosphate in infected cells. It is the triphosphate of DHPG that inhibits viral DNA polymerase and subsequently viral DNA synthesis. DHPG also shows in vitro and in vivo activity against cytomegalovirus (CMV) to a much higher degree than ACV.

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