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It has been specifically designed to overcome key resistance mechanisms that can limit the effectiveness of other nucleoside analogues, like cytarabine, that are currently used to treat AML.
[34] Various combinations of, or sequential therapy with, PEG IFNa and nucleoside analogues reduce HBsAg synthesis, but PEG-IFNa has restricted efficacy (Fig.
Based on what is understood about HBV infection, increasing the potency of nucleoside analogues, which are the mainstay of current HBV therapy, will only go so far toward absolute cure.
In the mid-1990s, researchers led by Prof McGuigan discovered an entirely new family of antivirals, called bicyclic nucleoside analogues (BCNAs).
Specific inclusion criteria were as follows: (1) at least 18 months following transplantation; (2) receiving a combined prevention regimen using nucleoside analogues and HBIG; and (3) liver function being normal or near normal.
Chemists and pharmacists here explore some of the techniques used to synthesize nucleoside analogues. Their topics include the chemical synthesis of acyclic nucleosides, mononucleotide pro-drug synthetic strategies, synthesizing conformally constrained nucleoside analogues, stereoselective methods in synthesizing bioactive oxathiolate and dioxolane nucleosides, and synthetic studies on antifungal peptidyl nucleoside antibiotics.
Seven drugs have received approval for the treatment of Chronic HBV infection including interferon alpha, pegylated interferon-alpha and the nucleoside analogues (NUCs) which belong to one of the three structural groups L-Nucleosides (Lamivudine (LMV) and Telbuvidine (LDT)), Alkyl phosphates (Adefovir Dipivoxil (ADF) and Tenefovir Dipivoxil Fumarate(TDF) and D- Cyclopentanes (Entecavir (ETV) Telbuvidine (LDT) is a novel orally administered nucleoside analogue for the use in the treatment of chronic HBV infection.
Studies have showed that antiviral therapy can significantly improve hepatitis B virus-related decompensated cirrhosis.1 Since interferon is not a good option for the treatment of decompensated cirrhosis, nucleoside analogues for hepatitis B virus has caught more and more attention.
Two types of antiviral medications can be used in the treatment of CHB: Interferon and the nucleoside analogues.8 Among the nucleoside analogues Lamivudine, Adefovir dipivoxil, Entecavir (ETV) and LdT have been approved by the United States FDA for the treatment of HBV.9 A major concern for this class of drugs is mitochondrial toxicity which is manifested as hepatic failure, nephrotoxicty, pancreatitis, neuropathy, myopathy and lactic acidosis.10 Furthermore emergence of drug resistance in patients on long term maintenance therapy with these drugs can result in diminished drug efficacy.11
The current standard of care for these infections is the use of oral nucleoside analogues, such as valacyclovir (Valtrex).
In resource-limited settings, combination chemotherapy consisting of 2 nucleoside analogues (reverse transcriptase inhibitors) [either zidovudine (AZT) or stavudine (d4T) along with lamivudine (3TC)] and 1 non-nucleoside reverse transcriptase inhibitor (NNRTI) [either nevirapine (NVP) or efavirenz (EFV)] are frequently used.

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