Antiviral Chemotherapy 5: New Directions For Clinical Application And Research (advances In Experimental Medicine And Biology)

Scientists and clinicians attending the last "New Directions in Antiviral Therapy" conference in late 1994 could hardly have predicted the revolution in the management of patients with HIV infection that has occurred since. Two new classes of antiretrovirals have been licensed, the second-site RT inhibitors and the protease inhibitors; the long in­ cubation period of active HIV infection, when the infection is clinically latent, is now un­ derstood to be a period of intense viral replication and turnover of CD4 lymphocytes; measurements of HI V RNA concentration in plasma have been shown to be essential tools for monitoring the course of HIV infection, deciding when to treat, and assessing the re­ sults of treatment; and finally, combinations of antiretrovirals, particularly combinations including protease inhibitors, have been shown to have dramatically beneficial effects on patients with HIV infection. These advances, coupled with new drugs for the management of herpesvirus infections, have made dramatic differences in the quality and length of life of HIV-infected patients. Additional advances have been made since 1994 in the prevention or management of influenza virus (zanamavir), respiratory syncytial virus (palvizumab), hepatitis B virus (lamivudine and famciclovir), and enterovirus infections (pleconaril). It is difficult to re­ member that only slightly more than a decade ago there were only a handful of antiviral agents available (none of which were antiretrovirals), and a number of those were either highly toxic, of dubious efficacy, or both. Front Matter....Pages i-viii Overview of HBV Therapy....Pages 1-10 Lamivudine Therapy of Chronic Hepatitis B....Pages 11-21 Famciclovir Update....Pages 23-27 Current Status of Antiviral Therapy for Chronic Hepatitis C....Pages 29-37 Prevention and Treatment of Respiratory Syncytial Virus Infections....Pages 39-53 Update on Influenza and Rhinovirus Infections....Pages 55-67 Pleconaril....Pages 69-76 Management of CMV Infections In HIV-Infected Patients....Pages 77-87 Management of Cytomegalovirus Infections in Blood and Marrow Transplant Recipients....Pages 89-109 Cidofovir....Pages 111-120 Oral Ganciclovir....Pages 121-127 Development of Novel Benzimidazole Riboside Compounds for Treatment of Cytomegalovirus Disease....Pages 129-134 Famciclovir/Penciclovir....Pages 135-147 Valaciclovir Update....Pages 149-157 Therapeutic Approaches to the Management of Herpes Zoster....Pages 159-165 Management of Varicella-Zoster Virus Infections in Children....Pages 167-174 Failure of HIV-1 Protease Inhibitors to Fully Suppress Viral Replication....Pages 175-182 New Reverse Transcriptase Inhibitors....Pages 183-197 HIV Viral Load Monitoring....Pages 199-212 Post-Exposure Prophylaxis for HIV....Pages 213-222 Antiretroviral Therapy in Primary HIV....Pages 223-227 Initial Treatment for HIV Infection....Pages 229-237 Strategies for Second-Line Antiretroviral Therapy in Adults with HIV Infection....Pages 239-266 Back Matter....Pages 267-271 This book is an edited expansion of a conference held in San Francisco in November 1997, at which a faculty of over 40 experts provided a comprehensive overview of the field of antiviral chemotherapy. The text discusses treatment issues and updates regarding HIV, herpes virus infections, influenza virus, respiratory syncytial virus, hepatitis B virus, and enterovirus infections.

Update on research reported at conference; clinical & experimental trials.