Prevention and Treatment of Viral Infections

Downloaded from http://aidsinfo.nih.gov/guidelines on 12/8/2012 EST. Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children Downloaded from http://aidsinfo.nih.gov/guidelines on 12/8/2012 EST. Visit the AIDSinfo website to access the most up-to-date guideline. Register for e-mail notification of guideline updates at http://aidsinfo.nih.gov/e-news. Downloaded from http://aidsinfo.nih.gov/guidelines on 12/8/2012 EST. department of health and human services Centers for Disease Control and Prevention Recommendations and Reports September 4, 2009 / Vol. 58 / No. RR-11 Morbidity and Mortality Weekly Report www.cdc.gov/mmwr Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children Recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics INSIDE: Continuing Education Examination Downloaded from http://aidsinfo.nih.gov/guidelines on 12/8/2012 EST. MMWR Editorial Board William L. Roper, MD, MPH, Chapel Hill, NC, Chairman Virginia A. Caine, MD, Indianapolis, IN Jonathan E. Fielding, MD, MPH, MBA, Los Angeles, CA David W. Fleming, MD, Seattle, WA William E. Halperin, MD, DrPH, MPH, Newark, NJ King K. Holmes, MD, PhD, Seattle, WA Deborah Holtzman, PhD, Atlanta, GA John K. Iglehart, Bethesda, MD Dennis G. Maki, MD, Madison, WI Sue Mallonee, MPH, Oklahoma City, OK Patricia Quinlisk, MD, MPH, Des Moines, IA Patrick L. Remington, MD, MPH, Madison, WI Barbara K. Rimer, DrPH, Chapel Hill, NC John V. Rullan, MD, MPH, San Juan, PR William Schaffner, MD, Nashville, TN Anne Schuchat, MD, Atlanta, GA Dixie E. Snider, MD, MPH, Atlanta, GA John W. Ward, MD, Atlanta, GA e MMWR series of publications is published by the Coordinating Center for Health Information and Service, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA 30333. Suggested Citation: Centers for Disease Control and Prevention. [Title]. MMWR 2009;58(No. RR-#):[inclusive page numbers]. Centers for Disease Control and Prevention omas R. Frieden, MD, MPH Director Tanja Popovic, MD, PhD Chief Science Officer James W. Stephens, PhD Associate Director for Science Steven L. Solomon, MD Director, Coordinating Center for Health Information and Service Jay M. Bernhardt, PhD, MPH Director, National Center for Health Marketing Katherine L. Daniel, PhD Deputy Director, National Center for Health Marketing Editorial and Production Staff Frederic E. Shaw, MD, JD Editor, MMWR Series Christine G. Casey, MD Deputy Editor, MMWR Series Susan F. Davis, MD Associate Editor, MMWR Series Teresa F. Rutledge Managing Editor, MMWR Series David C. Johnson (Acting) Lead Technical Writer-Editor Karen L. Foster, MA Project Editor Martha F. Boyd Lead Visual Information Specialist Malbea A. LaPete Stephen R. Spriggs Terraye M. Starr Visual Information Specialists Kim L. Bright Quang M. Doan, MBA Phyllis H. King Information Technology Specialists Disclosure of Relationship CDC, our planners, and our content specialists wish to disclose they have no financial interests or other relationships with the manufactures of commercial products, suppli- ers of commercial services, or commercial supporters, with the exception of Kenneth Dominguez, who serves on Advisory Board for Committee on Pediatric AIDS (COPD) – Academy of Pediatrics Prevention and Treatment of Viral Infections Prevention and Treatment of Viral Infections Bởi: OpenStaxCollege Viruses cause a variety of diseases in animals, including humans, ranging from the common cold to potentially fatal illnesses like meningitis ([link]) These diseases can be treated by antiviral drugs or by vaccines, but some viruses, such as HIV, are capable of both avoiding the immune response and mutating to become resistant to antiviral drugs Viruses can cause dozens of ailments in humans, ranging from mild illnesses to serious diseases (credit: modification of work by Mikael Häggström) 1/8 Prevention and Treatment of Viral Infections Vaccines for Prevention While we have limited numbers of effective antiviral drugs, such as those used to treat HIV and influenza, the primary method of controlling viral disease is by vaccination, which is intended to prevent outbreaks by building immunity to a virus or virus family ([link]) Vaccines may be prepared using live viruses, killed viruses, or molecular subunits of the virus The killed viral vaccines and subunit viruses are both incapable of causing disease Live viral vaccines are designed in the laboratory to cause few symptoms in recipients while giving them protective immunity against future infections Polio was one disease that represented a milestone in the use of vaccines Mass immunization campaigns in the 1950s (killed vaccine) and 1960s (live vaccine) significantly reduced the incidence of the disease, which caused muscle paralysis in children and generated a great amount of fear in the general population when regional epidemics occurred The success of the polio vaccine paved the way for the routine dispensation of childhood vaccines against measles, mumps, rubella, chickenpox, and other diseases The danger of using live vaccines, which are usually more effective than killed vaccines, is the low but significant danger that these viruses will revert to their disease-causing form by back mutations Live vaccines are usually made by attenuating (weakening) the “wild-type” (disease-causing) virus by growing it in the laboratory in tissues or at temperatures different from what the virus is accustomed to in the host Adaptations to these new cells or temperatures induce mutations in the genomes of the virus, allowing it to grow better in the laboratory while inhibiting its ability to cause disease when reintroduced into conditions found in the host These attenuated viruses thus still cause infection, but they not grow very well, allowing the immune response to develop in time to prevent major disease Back mutations occur when the vaccine undergoes mutations in the host such that it readapts to the host and can again cause disease, which can then be spread to other humans in an epidemic This type of scenario happened as recently as 2007 in Nigeria where mutations in a polio vaccine led to an epidemic of polio in that country Some vaccines are in continuous development because certain viruses, such as influenza and HIV, have a high mutation rate compared to other viruses and normal host cells With influenza, mutations in the surface molecules of the virus help the organism evade the protective immunity that may have been obtained in a previous influenza season, making it necessary for individuals to get vaccinated every year Other viruses, such as those that cause the childhood diseases measles, mumps, and rubella, mutate so infrequently that the same vaccine is used year after year 2/8 Prevention and Treatment of Viral Infections Vaccinations are designed to boost immunity to a virus to prevent infection (credit: USACE Europe District) Link to Learning Watch this NOVA video to learn how microbiologists are attempting to replicate the deadly 1918 Spanish influenza virus so they can understand more about virology Vaccines and Anti-viral Drugs for Treatment In some cases, vaccines can be used to treat an active viral infection The concept behind this is that by giving the vaccine, immunity is boosted without adding more diseasecausing virus In the case of rabies, a fatal neurological disease transmitted via the saliva of rabies virus-infected animals, the progression of the disease from the time of the animal bite to the time it enters the central nervous system may be weeks or longer This is enough time to vaccinate an individual who suspects that they have been bitten by a rabid animal, and their boosted immune response is sufficient to prevent the virus from entering nervous tissue Thus, the potentially fatal neurological consequences of the disease are averted, and the individual only has to recover from the infected bite This approach is also being used for the treatment of Ebola, one of the fastest and most deadly viruses on earth Transmitted by bats and great apes, this disease can cause death in 70–90 percent of infected humans within weeks Using newly developed vaccines that boost the immune response in this way, there is hope that affected ...Continue NCCN Clinical Practice Guidelines in Oncology™ Prevention and Treatment of Cancer- Related Infections V.2.2009 www.nccn.org Practice Guidelines in Oncology – v.2.2009 Prevention and Treatment of Cancer-Related Infections Version 2.2009, © 2009 National Comprehensive Cancer Network, Inc. All rights reserved. These guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN.08/28/09 Guidelines Index Prevention/Treatment Infection TOC Discussion, References NCCN ® NCCN Prevention and Treatment of Cancer-Related Infections Panel Members Brahm H. Segal, MD/Co-Chair Roswell Park Cancer Institute Lindsey Robert Baden, MD/Co-Chair Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center Corey Casper, MD, MPH Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance Erik Dubberke, MD Siteman Cancer Center at Barnes- Jewish Hospital and Washington University School of Medicine Alison G. Freifeld, MD UNMC Eppley Cancer Center at The Nebraska Medical Center Michael Gelfand, MD St. Jude Children's Research Hospital/University of Tennessee Cancer Institute John N. Greene, MD H. Lee Moffitt Cancer Center & Research Institute F F F F F F F Þ Þ Guido Marcucci, MD Arthur G. James Cancer Hospital & Richard J. Solove Research Institute at The Ohio State University Kieren A. Marr, MD The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Jose G. Montoya, MD Stanford Comprehensive Cancer Center Ashley Morris-Engemann, PharmD Duke Comprehensive Cancer Center Peter G. Pappas, MD University of Alabama at Birmingham Comprehensive Cancer Center Ken Rolston, MD The University of Texas M.D. Anderson Cancer Center Susan K. Seo, MD Memorial Sloan-Kettering Cancer Center Þ † F F F å Þ F X å Infectious diseases ‡ Hematology/Hematology oncology Þ Internal medicine Pulmonary medicine † Medical oncology Pharmacology * Writing committee member Continue John P. Greer, MD Vanderbilt-Ingram Cancer Center Michael G. Ison, MD, MS Robert H. Lurie Comprehensive Cancer Center at Northwestern University James I. Ito, MD City of Hope Judith E. Karp, MD The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Daniel R. Kaul, MD University of Michigan Comprehensive Cancer Center Earl King, MD Fox Chase Cancer Center Emily Mackler, PharmD University of Michigan Comprehensive Cancer Center ‡ F F F X å ‡Þ * * Not for Distribution Practice Guidelines in Oncology – v.2.2009 Prevention and Treatment of Cancer-Related Infections Version 2.2009, © 2009 National Comprehensive Cancer Network, Inc. All rights reserved. These guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN.08/28/09 Guidelines Index Prevention/Treatment Infection TOC Discussion, References NCCN ® Table of Contents Site Specific Evaluation and Therapy: Panel Members Summary of Guideline Updates Antimicrobial Prophylaxis (INF-1) Antibacterial Prophylaxis (INF-2) Antifungal Prophylaxis (INF-3) Antiviral Prophylaxis (INF-4) Antipneumocystis Prophylaxis (INF-5) Prevention of Cytomegalovirus Disease (INF-6) Fever and Neutropenia (FEV-1) Initial Therapy (FEV-2) Initial Risk Assessment for Febrile Neutropenic Patients (FEV-3) Mouth, Esophagus, and Sinus/Nasal (FEV-4) Abdominal Pain, Perirectal Pain, Diarrhea, Vascular Access Devices (FEV-5) Lung Infiltrates (FEV-6) Cellulitis, Wound, Vesicular Lesions, Disseminated Papules or Other Lesions, Urinary Tract Symptoms, Central Nervous System Symptoms (FEV-7) · · · · These guidelines are a statement of consensus of the authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these guidelines is BioMed Central Page 1 of 6 (page number not for citation purposes) Virology Journal Open Access Review Biochemical prevention and treatment of viral infections – A new paradigm in medicine for infectious diseases Hervé Le Calvez* 1 , Mang Yu 2 and Fang Fang 2 Address: 1 Abgent, Inc. 6310 Nancy Ridge Drive, Suite 106, San Diego, CA 92121 USA and 2 NexBio, Inc. 6330 Nancy Ridge Drive, Suite 105, San Diego, CA 92121 USA Email: Hervé Le Calvez* - lecalvez@abgent.com; Mang Yu - myu@nexbio.com; Fang Fang - ffang@nexbio.com * Corresponding author viral mRNAanti-sense oligonucleotideribozymeRNA interferenceviral infectious diseaseblocking antibodysoluble receptorrhinovirus Abstract For two centuries, vaccination has been the dominating approach to develop prophylaxis against viral infections through immunological prevention. However, vaccines are not always possible to make, are ineffective for many viral infections, and also carry certain risk for a small, yet significant portion of the population. In the recent years, FDA's approval and subsequent market acceptance of Synagis, a monoclonal antibody indicated for prevention and treatment of respiratory syncytial virus (RSV) has heralded a new era for viral infection prevention and treatment. This emerging paradigm, herein designated "Biochemical Prevention and Treatment", currently involves two aspects: (1) preventing viral entry via passive transfer of specific protein-based anti-viral molecules or host cell receptor blockers; (2) inhibiting viral amplification by targeting the viral mRNA with anti-sense DNA, ribozyme, or RNA interference (RNAi). This article summarizes the current status of this field. Introduction A landmark in the battle against viral infectious diseases was made in 1798 when Jenner first inoculated humans against smallpox with the less virulent cowpox. For about two centuries since then, humans relied almost exclu- sively on vaccines for protection against viruses. Only in the recent years, new strategies for controlling viral infec- tious diseases have emerged, which have so far led to a couple of viral prophylaxis/therapeutics on the market. These strategies are fundamentally different from vaccines in that they attempt to directly interrupt viral infectious life cycle at molecular level by using proteins or oligonu- cleotides. To differentiate them from the conventional vaccines that prevent viral infection by boosting immune system, we refer the new antiviral approaches as "Bio- chemical Prevention and Treatment" (see figure 1). Bio- chemical Prevention and Treatment, as an alternative to vaccines and chemical compound based antiviral drugs, may prove to be particularly valuable in the areas where vaccines and/or chemical drugs can not be generated or have not been successful in human, including diseases caused by some common pathogenic viruses, such as HIV, hepatitis C virus (HCV), RSV and human rhinovirus (HRV). In this review, we will discuss various molecular intervention approaches. Published: 23 November 2004 Virology Journal 2004, 1:12 doi:10.1186/1743-422X-1-12 Received: 10 November 2004 Accepted: 23 November 2004 This article is available from: http://www.virologyj.com/content/1/1/12 © 2004 Le Calvez et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.o BioMed Central Page 1 of 6 (page number not for citation purposes) Virology Journal Open Access Review Biochemical prevention and treatment of viral infections – A new paradigm in medicine for infectious diseases Hervé Le Calvez* 1 , Mang Yu 2 and Fang Fang 2 Address: 1 Abgent, Inc. 6310 Nancy Ridge Drive, Suite 106, San Diego, CA 92121 USA and 2 NexBio, Inc. 6330 Nancy Ridge Drive, Suite 105, San Diego, CA 92121 USA Email: Hervé Le Calvez* - lecalvez@abgent.com; Mang Yu - myu@nexbio.com; Fang Fang - ffang@nexbio.com * Corresponding author viral mRNAanti-sense oligonucleotideribozymeRNA interferenceviral infectious diseaseblocking antibodysoluble receptorrhinovirus Abstract For two centuries, vaccination has been the dominating approach to develop prophylaxis against viral infections through immunological prevention. However, vaccines are not always possible to make, are ineffective for many viral infections, and also carry certain risk for a small, yet significant portion of the population. In the recent years, FDA's approval and subsequent market acceptance of Synagis, a monoclonal antibody indicated for prevention and treatment of respiratory syncytial virus (RSV) has heralded a new era for viral infection prevention and treatment. This emerging paradigm, herein designated "Biochemical Prevention and Treatment", currently involves two aspects: (1) preventing viral entry via passive transfer of specific protein-based anti-viral molecules or host cell receptor blockers; (2) inhibiting viral amplification by targeting the viral mRNA with anti-sense DNA, ribozyme, or RNA interference (RNAi). This article summarizes the current status of this field. Introduction A landmark in the battle against viral infectious diseases was made in 1798 when Jenner first inoculated humans against smallpox with the less virulent cowpox. For about two centuries since then, humans relied almost exclu- sively on vaccines for protection against viruses. Only in the recent years, new strategies for controlling viral infec- tious diseases have emerged, which have so far led to a couple of viral prophylaxis/therapeutics on the market. These strategies are fundamentally different from vaccines in that they attempt to directly interrupt viral infectious life cycle at molecular level by using proteins or oligonu- cleotides. To differentiate them from the conventional vaccines that prevent viral infection by boosting immune system, we refer the new antiviral approaches as "Bio- chemical Prevention and Treatment" (see figure 1). Bio- chemical Prevention and Treatment, as an alternative to vaccines and chemical compound based antiviral drugs, may prove to be particularly valuable in the areas where vaccines and/or chemical drugs can not be generated or have not been successful in human, including diseases caused by some common pathogenic viruses, such as HIV, hepatitis C virus (HCV), RSV and human rhinovirus (HRV). In this review, we will discuss various molecular intervention approaches. Published: 23 November 2004 Virology Journal 2004, 1:12 doi:10.1186/1743-422X-1-12 Received: 10 November 2004 Accepted: 23 November 2004 This article is available from: http://www.virologyj.com/content/1/1/12 © 2004 Le Calvez et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.o Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents Downloaded from https://aidsinfo.nih.gov/guidelines on 8/17/2017 Visit the AIDSinfo website to access the most up-to-date guideline Register for e-mail notification of guideline updates at https://aidsinfo.nih.gov/e-news Downloaded from https://aidsinfo.nih.gov/guidelines on 8/17/2017 Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents Recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America How to Cite the Adult and Adolescent Opportunistic Infection Guidelines: Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf Accessed (insert date) [include page numbers, table number, etc if applicable] It is emphasized that concepts relevant to HIV management evolve rapidly The Panel has a mechanism to update recommendations on a regular basis, and the most recent information is available on the AIDSinfo website (http://aidsinfo.nih.gov) Downloaded from https://aidsinfo.nih.gov/guidelines on 8/17/2017 Access AIDSinfo mobile site What’s New in the Guidelines Updates to the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents The Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV Infected Adults and Adolescents document was published in an electronic format that could be easily updated as relevant changes in prevention and treatment recommendations occur The editors and subject matter experts are committed to timely changes in this document because so many health care providers, patients, and policy experts rely on this source for vital clinical information All changes are developed by the subject matter groups listed in the document (changes in group composition are also promptly posted) These changes are reviewed by the editors and by relevant outside reviewers before the document is altered Major revisions within the last months are as follows: August 10, 2017 Bacterial Enterics: This revision highlights new data from the CDC Health Advisory Network (April, 2017) indicating growing concern over fluoroquinolone resistant in Shigella isolates Fluoroquinolones should only be used to treated Shigella isolates when the MIC ... receptor of an immune cell and fuses with the cell membrane Viral contents are released into the cell, where viral enzymes convert 5/8 Prevention and Treatment of Viral Infections the single-stranded.. .Prevention and Treatment of Viral Infections Vaccines for Prevention While we have limited numbers of effective antiviral drugs, such as those used to treat HIV and influenza,... relies on their specificity and involves using bacteriophages in the treatment of bacterial infections Bacterial diseases have been 6/8 Prevention and Treatment of Viral Infections treated with antibiotics