Frequently used antiviral agents in the clinical environment

Article information

J Korean Med Assoc. 2011;54(5):530-536

Publication date (electronic) : 2011 May 11

doi : https://doi.org/10.5124/jkma.2011.54.5.530

Seunghoon Han, MD ¹^,², Dong-Seok Yim, MD ¹^,²

¹Department of Pharmacology, School of Medicine, The Catholic University of Korea, Seoul, Korea.

²Department of Clinical Pharmacology and Therapeutics, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

Corresponding author: Dong-Seok Yim, yimds@catholic.ac.kr

Received 2011 March 21; Accepted 2011 April 05.

Abstract

More than 60 antiviral agents for various infectious diseases such as herpes, hepatitis, influenza, and AIDS are currently prescribed worldwide. Among the viral infections, hepatitis B and influenza are those frequently seen in primary care situations in Korea. This review discusses the anti-hepatitis B (HBV) drugs entecavir and adefovir, and the anti-influenza drugs oseltamivir and zanamivir. In addition, the pharmacology and therapeutic guidance suggested by the Korean Association for the Study of the Liver were reviewed for entecavir and adepovir, the most frequently prescribed anti-HBV drugs. For influenza, oseltamivir is commonly used despite debates on neuropsychiatric safety issues and zanamivir may be used when an inhalation form is necessary. Although currently used drugs show considerable clinical efficacy, efforts to optimize their use and further research to find new molecules that may overcome their limitations are necessary.

Keywords: Antiviral agent; Hepatitis B; Influenza

References

1. Safrin S. In : Katzung BG, Masters SB, Trevor AJ, eds. Antiviral agents. Basic & clinical pharmacology 2009. New York: McGraw-Hill Medical; 845–876.

2. Lee KS, Kim DJ. Guideline Committee of the Korean Association for the Study of the Liver. Management of chronic hepatitis B. Korean J Hepatol 2007. 13447–488.

3. Shim JH, Lee HC, Kim KM, Lim YS, Chung YH, Lee YS, Suh DJ. Efficacy of entecavir in treatment-naive patients with hepatitis B virus-related decompensated cirrhosis. J Hepatol 2010. 52176–182.

4. Lee CS. The diagnosis and treatment of influenza. J Korean Med Assoc 2010. 5343–51.

5. Jackson RJ, Cooper KL, Tappenden P, Rees A, Simpson EL, Read RC, Nicholson KG. Oseltamivir, zanamivir and amantadine in the prevention of influenza: a systematic review. J Infect 2011. 6214–25.

6. Jefferson T, Jones M, Doshi P, Del Mar C. Neuraminidase inhibitors for preventing and treating influenza in healthy adults: systematic review and meta-analysis. BMJ 2009. 339b5106.

7. Toovey S, Rayner C, Prinssen E, Chu T, Donner B, Thakrar B, Dutkowski R, Hoffmann G, Breidenbach A, Lindemann L, Carey E, Boak L, Gieschke R, Sacks S, Solsky J, Small I, Reddy D. Assessment of neuropsychiatric adverse events in influenza patients treated with oseltamivir: a comprehensive review. Drug Saf 2008. 311097–1114.

8. Seo ES, Park GH, Kim SM, Kim SW, Jung WS, Cho KS, Park YG, Lee CK, Kang C, Lee JY, Choi WY. Oseltamivir efficacy, side effects, and safety in children with influenza. Korean J Pediatr 2010. 5356–66.

Article information Continued

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Table 1

Currently available antiviral agents for hepatits B and influenza

Table 2

Modification of dosing regimen of anti-hepatitis B agents in patients with renal impairment

HD, hemodialysis; CAPD, continuous ambulatory peritoneal dialysis.

^a)Double dose when use for patients with lamivudine resistance.

^b)Use syrup for doses less than 0.5 mg.

^c)Administer drug after dialysis.

^d)No evidence for patients whose creatinine clearance <10 mL/min without HD.

Table 3

Oseltamivir regimen for different purposes and patient groups