Antiviral Drugs Health Article

Definition

Antiviral drugs act against diseases caused by viruses.

Description

Viruses represent a large group of infective agents that are composed of a core of nucleic acids, either RNA or DNA, surrounded by a layer of protein. They are not really living organisms according to general understanding, since they lack the cell membrane that is associated with living cells. Viruses can reproduce only inside a living cell, and they cause many diseases. Viruses are not normally affected by antibiotics but a small number of viruses can either be destroyed or have their growth stopped by drugs.

The drugs as of 2004 available for treatment of viral diseases in children are:

• Acyclovir (Zovirax), used for treatment of diseases caused by the erpes simplex virus and herpes zoster virus. Although it is approved only for children over the age of six months, the drug has been used for newborn infants with encephalitis. This drug is most reliable when given intravenously.
• Amantidine (Symmetrel), used to prevent or treat infections of the influenza virus type A. It is recommended for patients who cannot or should not receive influenza virus vaccine. As of 2004 it has not been studied in children below the age of one year.
• Foscarnet (Foscavir), is not recommended for young children but may be given to adolescents. It is used to treat cytomegalovirus infections of the eye, and for herpes simplex infections that are resistant to other drugs.
• Ganciclovir (Cytovene), used to treat cytomegalovirus infections of the eye. Although the manufacturer does not recommend use of ganciclovir in patients below the age of 12 years, the drug is recommended by standard pediatric references for children as young as three months.
• Oseltamivir (Tamiflu), used for treatment of influenza virus infections of children over the age of 13 years. In adults, oseltamivir has also been used for prevention if influenza, but this use has not been studied in children.
• Ribavirin (Rebetol, Virazol), used for treatment of hospitalized infants and young children with severe lower respiratory tract infections caused by respiratory syncytial virus (RSV), but its value is controversial.
• Rimantidine (Flumadine), used to protect against the influenza virus type A.
• Valacyclovir (Valtrex), used for treatment of diseases caused by the herpes simplex virus and herpes zoster virus. This drug is converted to acyclovir inside the body and is more reliable for oral use. Although the manufacturer says that safety and efficacy in children have not been established, valacyclovir is recommended for use in standard pediatric resources.
• Vidarabine (Vira-A), used to treat severe herpes infections in the newborn, but its primary value is in the form of an eye ointment to treat herpes infections of the eye.
• Zanamivir (relenza), used to treat influenza infections caused by viruses types A and B in adults and children over the age of seven.

In addition to the above drugs, there are drugs which treat retrovirus infections. Retroviruses are composed of RNA molecules instead of DNA, and the only treatable one is the one that causes acquired immune deficiency syndrome (AIDS). The drugs in this group that are appropriate for treatment of children are as follows:

• abacavir (Ziagen)
• amprenavir (Agenerase), for children above the age of four
• didanosine (Videx)
• efavirenz (Sustiva), for children over the age of three
• indinavir (Crixavan), according to the manufacturer safety and efficacy of which in children has not been established, but the drug has been recommended in standard pediatric references
• lamivudine (Epivir), for treatment of hepatitis B as well as for AIDS
• lopinavir/Ritonavir fixed combination (Kaletra), used in children as young as six months
• stavudine (Zerit)
• nelfinavir (Viracept), the manufacturer of which does not recommend use of this drug for children younger than two, but it has been studied with some success in children as young as newborns
• ritonavir (Norvir)
• saquinavir (Fortovase, Invirase)
• zalcitabine (Hivid)
• zidovudine (Retrovir)

Other drugs for treatment of HIV disease are marketed, but there have been neither sufficient studies not clinical experience to recommend their use in children.

General use

The antiviral drugs are used to prevent or treat the diseases listed above. These drugs are specific for individual viruses and offer no benefit for conditions caused by other viruses.

Precautions

Each of the drugs listed has specific warnings. See specific drugs references or ask a pediatrician.