Keating M R
Division of Infectious Diseases and Internal Medicine, Mayo Clinic Rochester, Minnesota 55905, USA.
Mayo Clin Proc. 1999 Dec;74(12):1266-83. doi: 10.4065/74.12.1266.
Several new agents for treating viral infections have been developed in recent years. All available agents are virustatic, inhibiting specific steps in the process of viral replication. No agent is active against nonreplicating or latent viruses. Acyclovir is useful in the treatment of genital herpes, herpes simplex encephalitis, mucocutaneous herpetic infection, varicella infection in the immunosuppressed host, and herpes zoster infection in the normal and the immunosuppressed host. It can also be used for prevention of herpesvirus infection in immunocompromised patients. Ganciclovir is indicated for the treatment of cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome and is effective in the treatment and prevention of cytomegalovirus infection in other immunocompromised patients. Famciclovir and valacyclovir are effective in the management of herpes simplex and varicella-zoster infection. Amantadine and rimantadine are useful therapeutically and prophylactically in the management of influenza A virus infection. Chronic hepatitis B infection can respond to lamivudine therapy, and the optimal treatment of hepatitis C is the combination of interferon alfa and ribavirin. Despite pronounced toxic effects, foscarnet and cidofovir are effective antiviral agents in specific settings.
近年来已研发出几种治疗病毒感染的新型药物。所有现有药物均为病毒抑制剂,可抑制病毒复制过程中的特定步骤。没有药物对非复制型或潜伏型病毒有活性。阿昔洛韦可用于治疗生殖器疱疹、单纯疱疹性脑炎、黏膜皮肤疱疹感染、免疫抑制宿主中的水痘感染以及正常和免疫抑制宿主中的带状疱疹感染。它还可用于预防免疫功能低下患者的疱疹病毒感染。更昔洛韦适用于治疗获得性免疫缺陷综合征患者的巨细胞病毒性视网膜炎,对治疗和预防其他免疫功能低下患者的巨细胞病毒感染有效。泛昔洛韦和伐昔洛韦对单纯疱疹和水痘 - 带状疱疹感染的治疗有效。金刚烷胺和金刚乙胺在甲型流感病毒感染的治疗和预防中均有作用。慢性乙型肝炎感染对拉米夫定治疗有反应,丙型肝炎的最佳治疗方法是干扰素α和利巴韦林联合使用。尽管有明显的毒性作用,但膦甲酸钠和西多福韦在特定情况下是有效的抗病毒药物。