Antiviral therapy for respiratory tract infections
Identifieur interne : 001340 ( Main/Curation ); précédent : 001339; suivant : 001341Antiviral therapy for respiratory tract infections
Auteurs : Samson S. Y. Wong [Hong Kong] ; Kwok-Yung Yuen [Hong Kong]Source :
- Respirology [ 1323-7799 ] ; 2008-11.
English descriptors
- Teeft :
- Acyclovir, Adamantanes, Adenovirus, Adenovirus infection, Adenovirus infections, Adenovirus pneumonia, Agents chemother, Allogeneic, Allogeneic bone marrow transplantation, Allogeneic hematopoietic, Amantadine, Animal studies, Antimicrob, Antiviral, Antiviral agents, Antiviral susceptibility, Antiviral therapy, Antiviral treatment, Asian society, Asymptomatic, Authors journal compilation, Avian, Avian viruses, Bocavirus, Bone marrow transplant, Bone marrow transplantation, British columbia, Bronchiolitis, Bronchopulmonary dysplasia, Care facilities, Cell transplant, Cell transplant recipients, Cell transplantation, Chan, Chemoprophylaxis, Chemother, Cheng, Chronic lung diseases, Cidofovir, Clin, Clinical features, Clinical trials, Cochrane database syst, Combination therapy, Common causes, Commonest, Convalescent, Convalescent plasma, Coronavirus, Corticosteroid, Cytokine storm, Cytomegalovirus, Cytomegalovirus disease, Cytomegalovirus infection, Cytomegalovirus pneumonia, Disease severity, Dos, Echovirus, Elderly individuals, Elderly people, Emerg, Engl, European group, Fluav, Foscarnet, Ganciclovir, Haemophagocytic lymphohistiocytosis, Hayden, Hcmv, Hcmv disease, Hcmv infection, Hcmv pneumonitis, Healthy adults, Heart lung transplant, Hematopoietic, Herpes, Herpesvirus, High prevalence, High risk, Hmpv, Hong kong, Host cells, Hpiv, Hrsv, Hrsv infection, Human bocavirus, Human cytomegalovirus, Human herpesvirus, Human infection, Human metapneumovirus, Human metapneumovirus infection, Human parechovirus, Human rhinovirus, Human virus, Human viruses, Immunocompetent, Immunocompetent hosts, Immunocompromised, Immunocompromised hosts, Immunocompromised individuals, Immunocompromised patients, Immunoglobulin, Immunosuppressed hosts, Infection, Infectious diseases, Infectious mononucleosis, Inhibitor, Intensive care, Interferon, Intranasal, Intranasal interferon, Intravenous, Intravenous ribavirin, Ivig, Lancet, Loading dose, Lrti, Lung tissue, Lung transplant, Maintenance therapy, Marrow, Marrow transplantation, Measles, Measles pneumonia, Measles virus, Mechanical ventilation, Metapneumovirus, Microbiol, Mouse model, Mutation, Nasopharyngeal aspirate, Nebulized, Nebulized ribavirin, Neuraminidase, Neuraminidase inhibitors, Nosocomial, Nosocomial transmission, Oral inhalation, Oseltamivir, Oseltamivir resistance, Outbreak, Palivizumab, Parechovirus, Pathogen, Pediatr, Pediatrics, Peripheral blood, Pleconaril, Pneumonia, Pneumonitis, Pregnant women, Proc, Prophylaxis, Prospective study, Randomized, Recipient, Renal, Renal transplant recipients, Replication, Respir, Respiratory syncytial virus, Respiratory syncytial virus infection, Respiratory syncytial virus infections, Respiratory syndrome, Respiratory tract, Respiratory tract infections, Respirology, Rhinovirus, Rhinovirus infection, Rhinovirus infections, Ribavirin, Ribavirin therapy, Risk factors, Rsvig, Sars, Sars patients, Serotypes, Severe infections, Shorter duration, Simplex, Susceptibility, Syncytial, Syndrome, Systematic review, Therapy, Tract infection, Transplant, Transplant recipients, Transplantation, Valacyclovir, Valganciclovir, Varicella, Varicella pneumonia, Vidarabine, Viral, Viral clearance, Viral load, Virol, Virological, Virus, Virus infection, Virus infections, Wong, World health organization, Young children, Yuen, Zanamivir.
Abstract
Viruses are important pathogens causing respiratory tract infections both in the community and health‐care facility settings. They are extremely common causes of morbidity in the competent hosts and some are associated with significant mortality in the compromised individuals. With wider application of molecular techniques, novel viruses are being described and old viruses are found to have new significance in different epidemiological and clinical settings. Some of these emerging pathogens may have the potential to cause pandemics or global spread of a severe disease, as exemplified by severe acute respiratory syndrome and avian influenza. Antiviral therapy of viral respiratory infections is often unnecessary in the competent hosts because most of them are self‐limiting and effective agents are not always available. In the immunocompromised individuals or for infections caused by highly pathogenic viruses, such as avian influenza viruses (AIV), antiviral treatment is highly desirable, despite the fact that many of the agents may not have undergone stringent clinical trials. In immunocompetent hosts, antiviral therapy can be stopped early because adaptive immune response can usually be mounted within 5–14 days. However, the duration of antiviral therapy in immunosuppressed hosts depends on clinical and radiological resolution, the degree and duration of immunosuppression, and therefore maintenance therapy is sometimes needed after the initial response. Immunotherapy and immunoprophylaxis appear to be promising directions for future research. Appropriate and targeted immunomodulation may play an important adjunctive role in some of these infections by limiting the extent of end‐organ damage and multi‐organ failure in some fulminant infections.
Url:
DOI: 10.1111/j.1440-1843.2008.01404.x
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<term>Adamantanes</term>
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<term>Adenovirus infections</term>
<term>Adenovirus pneumonia</term>
<term>Agents chemother</term>
<term>Allogeneic</term>
<term>Allogeneic bone marrow transplantation</term>
<term>Allogeneic hematopoietic</term>
<term>Amantadine</term>
<term>Animal studies</term>
<term>Antimicrob</term>
<term>Antiviral</term>
<term>Antiviral agents</term>
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<term>Antiviral therapy</term>
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<term>Asian society</term>
<term>Asymptomatic</term>
<term>Authors journal compilation</term>
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<term>Avian viruses</term>
<term>Bocavirus</term>
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<term>Bone marrow transplantation</term>
<term>British columbia</term>
<term>Bronchiolitis</term>
<term>Bronchopulmonary dysplasia</term>
<term>Care facilities</term>
<term>Cell transplant</term>
<term>Cell transplant recipients</term>
<term>Cell transplantation</term>
<term>Chan</term>
<term>Chemoprophylaxis</term>
<term>Chemother</term>
<term>Cheng</term>
<term>Chronic lung diseases</term>
<term>Cidofovir</term>
<term>Clin</term>
<term>Clinical features</term>
<term>Clinical trials</term>
<term>Cochrane database syst</term>
<term>Combination therapy</term>
<term>Common causes</term>
<term>Commonest</term>
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<term>Cytokine storm</term>
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<term>Cytomegalovirus disease</term>
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<term>Cytomegalovirus pneumonia</term>
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<term>Echovirus</term>
<term>Elderly individuals</term>
<term>Elderly people</term>
<term>Emerg</term>
<term>Engl</term>
<term>European group</term>
<term>Fluav</term>
<term>Foscarnet</term>
<term>Ganciclovir</term>
<term>Haemophagocytic lymphohistiocytosis</term>
<term>Hayden</term>
<term>Hcmv</term>
<term>Hcmv disease</term>
<term>Hcmv infection</term>
<term>Hcmv pneumonitis</term>
<term>Healthy adults</term>
<term>Heart lung transplant</term>
<term>Hematopoietic</term>
<term>Herpes</term>
<term>Herpesvirus</term>
<term>High prevalence</term>
<term>High risk</term>
<term>Hmpv</term>
<term>Hong kong</term>
<term>Host cells</term>
<term>Hpiv</term>
<term>Hrsv</term>
<term>Hrsv infection</term>
<term>Human bocavirus</term>
<term>Human cytomegalovirus</term>
<term>Human herpesvirus</term>
<term>Human infection</term>
<term>Human metapneumovirus</term>
<term>Human metapneumovirus infection</term>
<term>Human parechovirus</term>
<term>Human rhinovirus</term>
<term>Human virus</term>
<term>Human viruses</term>
<term>Immunocompetent</term>
<term>Immunocompetent hosts</term>
<term>Immunocompromised</term>
<term>Immunocompromised hosts</term>
<term>Immunocompromised individuals</term>
<term>Immunocompromised patients</term>
<term>Immunoglobulin</term>
<term>Immunosuppressed hosts</term>
<term>Infection</term>
<term>Infectious diseases</term>
<term>Infectious mononucleosis</term>
<term>Inhibitor</term>
<term>Intensive care</term>
<term>Interferon</term>
<term>Intranasal</term>
<term>Intranasal interferon</term>
<term>Intravenous</term>
<term>Intravenous ribavirin</term>
<term>Ivig</term>
<term>Lancet</term>
<term>Loading dose</term>
<term>Lrti</term>
<term>Lung tissue</term>
<term>Lung transplant</term>
<term>Maintenance therapy</term>
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<term>Marrow transplantation</term>
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<term>Measles virus</term>
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<term>Mouse model</term>
<term>Mutation</term>
<term>Nasopharyngeal aspirate</term>
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<term>Nebulized ribavirin</term>
<term>Neuraminidase</term>
<term>Neuraminidase inhibitors</term>
<term>Nosocomial</term>
<term>Nosocomial transmission</term>
<term>Oral inhalation</term>
<term>Oseltamivir</term>
<term>Oseltamivir resistance</term>
<term>Outbreak</term>
<term>Palivizumab</term>
<term>Parechovirus</term>
<term>Pathogen</term>
<term>Pediatr</term>
<term>Pediatrics</term>
<term>Peripheral blood</term>
<term>Pleconaril</term>
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<term>Pneumonitis</term>
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<term>Proc</term>
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<term>Randomized</term>
<term>Recipient</term>
<term>Renal</term>
<term>Renal transplant recipients</term>
<term>Replication</term>
<term>Respir</term>
<term>Respiratory syncytial virus</term>
<term>Respiratory syncytial virus infection</term>
<term>Respiratory syncytial virus infections</term>
<term>Respiratory syndrome</term>
<term>Respiratory tract</term>
<term>Respiratory tract infections</term>
<term>Respirology</term>
<term>Rhinovirus</term>
<term>Rhinovirus infection</term>
<term>Rhinovirus infections</term>
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<term>Sars patients</term>
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<term>Susceptibility</term>
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<term>Systematic review</term>
<term>Therapy</term>
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<term>Transplant</term>
<term>Transplant recipients</term>
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<front><div type="abstract" xml:lang="en">Viruses are important pathogens causing respiratory tract infections both in the community and health‐care facility settings. They are extremely common causes of morbidity in the competent hosts and some are associated with significant mortality in the compromised individuals. With wider application of molecular techniques, novel viruses are being described and old viruses are found to have new significance in different epidemiological and clinical settings. Some of these emerging pathogens may have the potential to cause pandemics or global spread of a severe disease, as exemplified by severe acute respiratory syndrome and avian influenza. Antiviral therapy of viral respiratory infections is often unnecessary in the competent hosts because most of them are self‐limiting and effective agents are not always available. In the immunocompromised individuals or for infections caused by highly pathogenic viruses, such as avian influenza viruses (AIV), antiviral treatment is highly desirable, despite the fact that many of the agents may not have undergone stringent clinical trials. In immunocompetent hosts, antiviral therapy can be stopped early because adaptive immune response can usually be mounted within 5–14 days. However, the duration of antiviral therapy in immunosuppressed hosts depends on clinical and radiological resolution, the degree and duration of immunosuppression, and therefore maintenance therapy is sometimes needed after the initial response. Immunotherapy and immunoprophylaxis appear to be promising directions for future research. Appropriate and targeted immunomodulation may play an important adjunctive role in some of these infections by limiting the extent of end‐organ damage and multi‐organ failure in some fulminant infections.</div>
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