HCV can cause chronic?
Infection, cirrhosis and carcinoma
How to Entecavir work?
It slows the progression of chronic hepatitis B infection and improves liver inflammation and fibrosis caused by HBV
An inflammation of the liver from any cause
Is a viral disease that causes inflammation of the liver
Hepatitis can be A-?
Acute viral Hepatitis?
Inflammation of the liver that begins suddenly and lasts a few weeks
HBV is spread by?
Sexual contact, perinatal
Entecavir and Lamivudine are?
Nucleoside RTI Treat HBV
Telaprevir, Simeprevir and Boceprevir are all? What do they so?
HCV NS3/4A protease inhibitors Inhibit replication by blocking the proteolytic activity of HCV protease NS3/4A
Tenofovir and Adefovir are both?
Nucleotide reverse transcriptase inhibitors
Chronic viral hepatitis?
Irreversible inflammatory disease of the liver a leading cause of death
Interactions of HCV protease inhibitor drugs?
Act as inhibitors and substrates of CYP3A4 (boceprevir>telaprevir>simeprevir) • Also inhibitors and substrates of efflux transporter P-glycoprotein • Watch for interactions with other drugs that undergo same metabolism
Hepatitis B is a ____ virus _____
dsDNA virus hepadnavirus
What is the life cycle of HCV?
- Viral entry into the cells - Replication of the HCV genome depends on NS5B RNA replicase which subsequently converts genomic (t) RNA into (-) and back to (+) RNA - The messenger RNAs formed during the replicative cycle of HCV are translated to viral precursor proteins that are then cleaved by virus-encoded protease NS3/4A into mature structural and functional protein
What is sofosbuvirs MOA?
Sofosbuvir blocks the NS5B RNA-dependent RNA polymerase of HCV
Complications of chronic HBV include?
Cirrhosis- scarring of the liver 2) Decompensated cirrhosis - Increase in portal HTN - Splenomegaly - Encephalopathy - Jaundice 3) Hepatic Carcinoma
IMP dehydrogenase inhibitor, crucial in making RNA including viral RNA
Cirrhosis and hepatocellular carcinoma
HCV RNA polymerase NtRTI inhibitor
Entecavir is the most ___ so far?
HCV virus type
Single stranded RNA flaviviridae (Like dengue, yellow fever)
What are the common side effects of Entecavir?
Diarrhea, Headache, Fatigue, chills, vomit, anorexia
HBV relies on what type of transcription?
Reverse transcription RNA--->DNA
Telaprevir, Simeprevir and Boceprevir should always be used in combination with?
Ribavirin and Interferon alfa-2b
Interferon alfa-2a or 2b act similarly to endogenous IFN-α to inhibit viral replication and cleave single-stranded viral RNA.
Problems and adverse effects of HCV protease inhibitors?
Resistance to both drugs has been demonstrated in HCV isolated from cell cultures and during clinical studies • Skin rash (in some case systemic symptoms-> fatal)