Medical Microbiology

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404 7 GeneralVirology

afteraninfectionorinsituationsinvolvingahighriskofinfection,e.g.,
toprotectagainsthepatitisBandrabies(locally,bitewound).Table 1. 13
(p. 3 3)andTable8. 7 (rabies,p. 47 0)listthemostimportantvaccines.

Chemotherapy


&Inhibitorsofcertainstepsinviralreplicationcanbeusedaschemo-
therapeuticagentstotreatviralinfections.Inpracticalterms,itismuch
moreimportanttoinhibitthesynthesisofviralnucleicacidthanofviral
proteins.Themainobstaclesinvolvedarethelowlevelofspecificityof
theagentsinsomecases(toxiceffectsbecausecellularmetabolismisalso
affected)andthenecessityofcommencingtherapyveryearlyintheinfection
cycle. &

Problemsofchemotherapy.Asdescribedonp. 381 ,viralreplicationiscom-
pletelyintegratedincellmetabolism.Thevirussuppliesonlythegeneticin-

Table 7. 4 TheMostImportantAntiviralChemotherapeutics

Chemotherapeuticagent Effect/indication

Adamantanamin
(amantadine)

Inhibitionofuncoatingininfluenzaviruses

Acycloguanosine
(acyclovir,Zovirax)

InhibitionofDNAsynthesisinHSVandVZV

Dihydropropoxymethylguanosine
(DHPG,ganciclovir,Cymevene)

InhibitionofDNAsynthesisinCMV

Ribavirin InhibitionofmRNAsynthesisandcapping.
InfectionswithLassavirusandperhapsin
severeparamyxovirusandmyxovirusinfec-
tions
NucleosideRTinhibitors(NRTI) InhibitionofRTinHIV(p.454)
Phosphonoformate
(foscarnet)

InhibitionofDNAsynthesisinherpesviruses,
HIV,HBV
Proteaseinhibitors InhibitionofviralmaturationinHIV
Neuraminidaseinhibitors Inhibitionofreleaseofinfluenzaviruses
AntisenseRNA ComplementarytoviralmRNA,whichit
blocksbymeansofhybridization(duplexing)

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Kayser, Medical Microbiology © 2005 Thieme
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