Viral infection hepatitis

Biological products were developed traditionally, before recombinant proteins, as extracts or derivatives of the actual protein from the human body or nature. This approach continues today and Table 15 lists 18 such products, mostly blood derivatives for therapeutic use. Albumin is obtained for cardiovascular volume conditions. A fish protein is harvested for osteoporosis. Igs extracted from blood are available for immunodeficiency conditions, viral infections (hepatitis-B and vaccinia), hemolytic anemia in newborns, and idiopathic thrombocytopenic purpurea. Antihemophilic products are still derived from blood. An antiglobulin is produced for kidney transplant rejection. A collagen product and two botulinum toxin products are used for various facial wrinkle problems and cervical dystonia. A bacterial antigen is formulated to enhance immunity to treat a cancer. 

Ara-A-5 -monophosphate [29984-33-6] (ara-AMP), C2QH24N OyP, is more water-soluble than ara-A, and therefore can be used in higher dosage during the first hours of treatment of viral infections. Ara-AMP has been shown to decrease virion-associated DNA polymerase concentrations in ground squirrels carrying ground squirrel hepatitis vims. The hypoxanthine derivative, ara-HxMP [54656-49-4] (24) is more water-soluble, appears to have a similar antiviral spectmm to ara-A, and is considerably less toxic (48). 

Abstract In 2007, the world celebrated the 50th anniversary of the discovery of interferon (IFN) by Isaacs and Lindemnann. Subsequently, the IFN-a gene was cloned, fully sequenced and IFN-a was produced in recombinant form. Recombinant IFN-a is now used as the basis for treatment of chronic hepatitis C virus infection and can also be used to treat certain forms of chronic hepatitis B virus infections. IFNs have also been used in other viral infections, although with less success. The antiviral mechanisms of IFNs are reviewed in this chapter as well as the utility of IFNs in the treatment of persistent viral infections. 

Table 4 Treatment of viral infections other than chronic viral hepatitis and HIV with type I IFNs...

In conclusion, IFNs have proven to be invaluable tools in the fight against chronic viral hepatitis. In these indications, their antiviral properties play a major role and it remains unclear whether their immunomodulatory properties are also important. Disappointing results obtained with purely immunomodulatory molecules, such as interleukins or Toll-like receptor agonists suggest that, if immunomodulation plays any role, potent inhibition of viral replication is also needed. The role of IFNs in the treatment of viral infections other than hepatitis B and C remains elusive. 

In pharmacology, two adamantane derivatives. Amantadine (1-adamanta-neamine hydrochloride) and Rimantadine (a-methyl-1-adamantane methyla-mine hydrochloride) (see Fig. 24), have been well known because of their antiviral activity [129]. The main application of these drugs is prophylaxis (treatment to prevent the onset of a particular disease) and treatment of influenza-A viral infections. They are also used in the treatment of parkinsonism and inhibition of hepatitis-C virus. Memantine (1-amino-3,5-dimethyladaman-tane) (see Fig. 24) has been reported effective in slowing the progression of Alzheimer s disease [130]. 

Vaccination against hepatitis A and B is recommended in patients with underlying cirrhosis to prevent additional liver damage from an acute viral infection.35 Pneumococcal and influenza vaccination may also be appropriate and can reduce hospitalizations due to influenza or pneumonia. 

Viral replication occurs when hepatitis B envelope antigen (HBeAg) is present and circulating in the blood. HBV DNA is utilized to measure viral infectivity and assess and quantify viral replication. Once the hepatitis B infection resolves, antibodies against hepatitis B envelope (anti-HBe) and... 

Suggested Alternatives for Differential Diagnosis Hepatitis, meningitis, Rocky Mountain spotted fever, malaria, yellow fever, leptospirosis, rickettsioses, river viruses, scrub typhus, typhoid, and other viral infections. 

Because ofthe reports of aplastic anemia (1 in 3,000 patients) and hepatitis (1 in 10,000 patients), it is now recommended only for patients refractory to other AEDs. Risk factors for aplastic anemia may be a history of cytopenia, AED allergy or toxicity, viral infection, and/or immunologic problems. 

Natural source may carry risk of infection. Recombinant Factor VIII used to treat hemophilia A has helped reduce the incidence of HIV infection in hemophiliacs. Recombinant HbsAg is now used to immunize against hepatitis B, eliminating the risk of introducing a viral infection during vaccination. 

Once the virus has achieved an intracellular location, it is protected from antibodies and only cell-mediated immunity is effective. Difficulties in producing effective vaccines against some viral infections, such as HIV, herpes simplex and hepatitis, have spurred the development of new strategies that use DNA rather than protein. 

Prophylaxis for malaria includes the administration of antimalarial tablets and protection against mosquito bites but does not include any vaccinations. Hepatitis C is a viral infection and no vaccine is available. Hepatitis B is a viral infection and prophylaxis is provided by a vaccine. 

Tinea pedis is a fungal infection commonly known as athlete s foot. Chickenpox is a childhood infection caused by the herpes zoster virus. Hepatitis is a viral infection of the liver. Mumps is a viral infection characterised by bilateral or unilateral inflammation of the salivary glands. Rubella (German measles) is caused by the rubella virus. 

Flisiak R, Dumont J-M, Crabbe R. (2007) Cyclophilin inhibitors in hepatitis C viral infection. Expert Opin Invest Drugs 16 1345-1354. 

Microscopic investigation of the mice from group I revealed the presence of vessel congestion, small numerous intralobular and perivenular infiltrates, moderate focal protein-hydropic degeneration combined with polymorphism of hepatocyte nuclei and inconstant lymphoid infiltration of portal tracts. Marked activation of histiomacrophage elements — hepatic macrophages must be emphasized. Homotypic moderate inflammatory alterations remained in the liver on Days 3, 5, 7 and 10. The presence of inflammatory mononuclear infiltration in the walls of central veins, typical for a viral infection, reflects a massive lesion of the vascular... 

Anti-hepatitis B virus activity in vitro and in vivo was also found in wogonin and baicalein (Fig. 4), the major active constituents of the traditional Chinese medicine Scutellaria radix.More recently, Blach-Olszewska et al investigated the effect of baicalein and wogonin on two important mechanisms of innate immunity The secretion of cytokines, and the natural resistance of human leukocytes to viral infection. The results obtained indicate that these fiavonoids modulate cytokine production, that is they inhibit interferons-a and -y, and stimulate tumor necrosis factor-a and interleukin production. They also augment the resistance of peripheral blood leukocytes to the vesicular stomatitis virus. 

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