Overview – Antiviral Agents and Treatment of CMV Retinitis – Antiviral Drugs

00:00 So just as an overview, I have here a list of the different agents and which viruses they are particularly active against and I've listed the primary versus the secondary drugs.

00:12 So in cytomegalovirus, the primary drugs are ganciclovir. In HSV and VZV, acyclovir is a primary drug. In hepatitis B virus, interferon alpha is a very very effective treatment.

00:27 Influenza A, you're probably quite familiar with this agent. You may even have taken it yourself. And also influenza B, it's also quite active as well. Now, we're going to talk about some specialized treatment issues. Let's talk about CMV retinitis. So, we will also cover this in the ophthalmology portions of our lectures. But just to get an idea of these agents now, in terms of sight- threatening lesions that are often found adjacent, for example, to the optic nerve or to the fovea, we will use intravitreal injections of ganciclovir. Sometimes, we'll use intravitreal injections of foscarnet as well. Now these are obviously administered by an ophthalmologist. Now, for systemic cytomegalovirus therapy, we may use valganciclovir which is used orally twice a day for up to 3 weeks. Alternatives include ganciclovir. So, intravitreal and systemic therapies are a little bit different. So remember the intravitreal injections are exceedingly, exceedingly effective in CMV retinitis.

01:42 In terms of peripheral non-sight-threatening lesions, we'll use systemic therapy.