RESUMEN
Over the past forty years, there has been a great advance in antiviral infections treatment. The discovery of acyclovir in 1977 paved the way to new antiviral drugs. Other nucleoside analogues such as valacyclovir, penciclovir, famciclovir, ganciclovir, valganciclovir, cidofovir and foscarnet were made available, as well as neuraminidase inhibitors. Also, drugs for the treatment of viral hepatitis and patients with HIV/AIDS have not only increased life quality and expectancy, but also decreased the incidence of some viral infections. Antiviral drugs are important tools to the clinician, especially when treating patients with impaired immunological and clinical condition. Aiming to restore health and prevent further adverse events, the clinician must be aware of the best antiviral drug available, its proper route of administration and dosage. The aim of this review is to present the antiviral drugs currently available, focusing on treatment of common viral infections in clinical practice. A brief description of the mechanisms of action and prescription of antiviral drugs is presented, using the data available from evidence-based medicine.
Asunto(s)
Antivirales , Orthomyxoviridae , Simplexvirus , Herpesvirus Humano 3 , CitomegalovirusRESUMEN
Viral acute gastroenteritis (AG) is a significant cause of hospitalisation in children younger than five years. Group A rotavirus (RVA) is responsible for 30% of these cases. Following the introduction of RVA immunisation in Brazil in 2006, a decreased circulation of this virus has been observed. However, AG remains an important cause of hospitalisation of paediatric patients and only limited data are available regarding the role of other enteric viruses in these cases. We conducted a prospective study of paediatric patients hospitalised for AG. Stool samples were collected to investigate human adenovirus (HAdV), RVA, norovirus (NoV) and astrovirus (AstV). NoV typing was performed by nucleotide sequencing and phylogenetic analysis. From the 225 samples tested, 60 (26%) were positive for at least one viral agent. HAdV, NoV, RVA and AstV were detected in 16%, 8%, 6% and 0% of the samples, respectively. Mixed infections were found in nine patients: HAdV/RVA (5), HAdV/NoV (3) and HAdV/NoV/RVA (1). The frequency of fever and lymphocytosis was significantly higher in virus-infected patients. Phylogenetic analysis of NoV indicated that all of these viruses belonged to genotype GII.4. The significant frequency of these pathogens in patients with AG highlights the need to routinely implement laboratory investigations.
Asunto(s)
Niño , Humanos , Infecciones por Virus ADN/virología , Heces/virología , Gastroenteritis/virología , Enfermedad Aguda , Adenovirus Humanos/genética , Adenovirus Humanos/aislamiento & purificación , Brasil , Genotipo , Hospitalización , Mamastrovirus/genética , Mamastrovirus/aislamiento & purificación , Norovirus/genética , Norovirus/aislamiento & purificación , Filogenia , Estudios Prospectivos , Reacción en Cadena en Tiempo Real de la Polimerasa , ARN Viral/genética , Rotavirus/genética , Rotavirus/aislamiento & purificación , Estaciones del AñoRESUMEN
Foram estudados 100 pacientes ambulatoriais pertencentes ao Programa de Hipertensäo Arterial do Hospital Nossa Senhora das Graças. A aderência ao tratamento foi quantificada através da freqüência dos pacientes as consultas e da resposta clínica a terapêutica instituída. O índice de comparecimento antes do início das reuniöes foi de 77% e após o início das mesmas foi de 83%. A taxa de resposta positiva a terapêutica foi de 75% e o abandono ocorreu em 25% dos casos