Bean B
Department of Pathology, Humana Hospital-Michael Reese, Chicago, Illinois 60616.
Clin Microbiol Rev. 1992 Apr;5(2):146-82. doi: 10.1128/CMR.5.2.146.
Drugs capable of inhibiting viruses in vitro were described in the 1950s, but real progress was not made until the 1970s, when agents capable of inhibiting virus-specific enzymes were first identified. The last decade has seen rapid progress in both our understanding of antiviral therapy and the number of antiviral agents on the market. Amantadine and ribavirin are available for treatment of viral respiratory infections. Vidarabine, acyclovir, ganciclovir, and foscarnet are used for systemic treatment of herpesvirus infections, while ophthalmic preparations of idoxuridine, trifluorothymidine, and vidarabine are available for herpes keratitis. For treatment of human immunodeficiency virus infections, zidovudine and didanosine are used. Immunomodulators, such as interferons and colony-stimulating factors, and immunoglobulins are being used increasingly for viral illnesses. While resistance to antiviral drugs has been seen, especially among AIDS patients, it has not become widespread and is being intensely studied. Increasingly, combinations of agents are being used: to achieve synergistic inhibition of viruses, to delay or prevent resistance, and to decrease dosages of toxic drugs. New approaches, such as liposomes carrying antiviral drugs and computer-aided drug design, are exciting and promising prospects for the future.
20世纪50年代就有了在体外能够抑制病毒的药物，但直到70年代才取得实质性进展，那时首次发现了能够抑制病毒特异性酶的药物。在过去十年里，我们对抗病毒治疗的理解以及市场上抗病毒药物的数量都取得了快速进展。金刚烷胺和利巴韦林可用于治疗病毒性呼吸道感染。阿糖腺苷、阿昔洛韦、更昔洛韦和膦甲酸钠用于全身治疗疱疹病毒感染，而碘苷、三氟胸腺嘧啶核苷和阿糖腺苷的眼科制剂可用于治疗疱疹性角膜炎。齐多夫定和去羟肌苷用于治疗人类免疫缺陷病毒感染。免疫调节剂，如干扰素和集落刺激因子，以及免疫球蛋白越来越多地用于治疗病毒性疾病。虽然已经出现了对抗病毒药物的耐药性，尤其是在艾滋病患者中，但尚未广泛传播，并且正在深入研究。越来越多地使用联合用药：以实现对病毒的协同抑制、延缓或预防耐药性以及减少毒性药物的剂量。新的方法，如携带抗病毒药物的脂质体和计算机辅助药物设计，为未来带来了令人兴奋和充满希望的前景。
