How are viral diseases treated?

Treatment of viral infections varies depending on the specific virus and other factors. General treatment measures are aimed at relieving your symptoms so that you can get the rest you need to keep up your strength and recover without developing complications.

General treatments for viral infections include:

    Acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) for fever, body aches, and pain

    Drinking extra fluids

    Getting extra rest and sleep

    Maintaining good nutrition

Depending on the type of viral infection and the presence of complications, a wide variety of other treatments may be needed. For example, a human papillomavirus (HPV) infection that leads to cervical dysplasia can be treated by surgical removal of the abnormal cells on a woman’s cervix.  

In general, it is recommended that children younger than age six not use cold or cough medications because of the risk for serious side effects. In addition, people with a viral disease should not use aspirin or products that contain aspirin because of the risk of developing a rare but life-threatening condition called Reye syndrome. Reye syndrome has been linked to taking aspirin during a viral illness, such as a cold or the flu.
Prescription medications used to treat viral diseases

In some cases, certain medications may be prescribed to treat viral diseases:

    Antiretroviral medications, which can help people with HIV/AIDS lead longer lives. Antiretroviral medications hinder the ability of HIV to reproduce, which slows the spread of HIV in the body.

    Antiviral drugs, which minimize the severity and length of some viral infections, such as the flu and shingles, especially in people who are at a high risk for serious complications. For example, the drugs oseltamivir (brand name Tamiflu) and zanamivir (brand name Relenza) may be prescribed for some cases of flu. These drugs are not appropriate for all people with the flu.

Antibiotics, which are not prescribed for viral diseases because they are ineffective in the treatment of viral infections, may be prescribed if a person with a viral disease develops a secondary bacterial infection, such as bacterial pneumonia, bacterial bronchitis, or encephalitis.
Complementary treatments

Complementary and traditional treatments will not cure a viral disease but may help to increase comfort, promote rest, and minimize symptoms of viral diseases. 

Management of HIV in Pregnancy

HIV infection in young children most commonly arises as a result of mother-to-child transmission (MTCT). It is thought that only 1.5-2% of MTCT occurs transplacentally during pregnancy. The vast majority occurs due to maternofetal transmission of blood during parturition or postnatal breast-feeding.

All pregnant women are recommended screening for HIV infection, syphilis, hepatitis B and rubella in every pregnancy at their booking antenatal visit. If a woman declines an HIV test, this should be documented in the maternity notes, her reasons should be sensitively explored and screening offered again at around 28 weeks.

A negative maternal HIV test at booking does not preclude neonatal infection - maternal infection and seroconversion can occur at any time during pregnancy and lactation. This is well-documented in countries with a high prevalence of HIV and has been seen in the UK.

Risk of mother-to-child transmission (MTCT)

This is increased with:

    Higher levels of maternal viraemia.
    HIV core antigens.
    Lower maternal CD4 count.
    Primary HIV Infection occurring during pregnancy.
    Chorioamnionitis.
    Co-existing other sexually transmitted disease (and malaria - possibly).
    Invasive intrapartum procedures, eg fetal scalp electrodes, forceps, ventouse.
    Rupture of membranes (especially if delivery is more than 4 hours after the membranes ruptured).
    Vaginal delivery.
    Preterm birth
    Female babies more likely to be infected early (transplacental/perinatal routes).
    Advanced maternal age.
    The firstborn of twins (born to an HIV-infected mother).

Factors that decrease risk of transmission are:

    Higher levels of neutralising HIV antibody.
    Elective Caesarean section.
    Zidovudine (ZDV)
    Less invasive monitoring and intrapartum procedures.

Management

Mother-to-child transmission (MTCT) of HIV infection can be greatly reduced through early diagnosis of maternal HIV infection.

    Pregnant women should be offered screening for HIV early in pregnancy because appropriate antenatal interventions can reduce MTCT of HIV infection.
    Interventions to reduce MTCT of HIV during the antenatal period include antiretroviral therapy, elective Caesarean section delivery and avoidance of breast-feeding after delivery.
    These interventions can reduce the risk of mother-to child HIV transmission from 25-30% to less than 1%.
    All pregnant women who are HIV-positive should be screened and appropriately treated for genital infections during pregnancy. This should be done as early as possible in pregnancy and repeated at about 28 weeks.
    Presentation with symptoms or signs of pre-eclampsia, cholestasis or other signs of liver dysfunction during pregnancy may indicate drug toxicity, and early liaison with HIV physicians is essential.

Drug therapy

Women who require HIV treatment for their own health should take highly active antiretroviral therapy (HAART) and continue treatment postpartum. They may also require prophylaxis against pneumocystic pneumonia (PCP), depending on their CD4 lymphocyte count.

Women already taking HAART and/or PCP prophylaxis before pregnancy should not discontinue their medication.

    Antiretroviral therapy is given to prevent MTCT and to prevent maternal disease progression. The optimal regimen is determined on a case-by-case basis.
    Zidovudine (ZDV) is indicated for use in pregnancy for prevention of MTCT of HIV but single-agent ZDV therapy which does not suppress plasma viraemia to undetectable levels may allow the emergence of resistant virus.
    Potent combinations of three or more antiretroviral drugs (HAART) have now become the standard of care. Women with advanced HIV should be treated with a HAART regimen. The start of treatment should be deferred until after the first trimester, if possible, and should be continued after delivery.
    For women who do not require HIV treatment for their own health, HAART should be initiated between 20 and 28 weeks and discontinued at delivery. If they have a plasma viral load of less than 10,000 copies/ml and are prepared to be delivered by elective Caesarean section, an acceptable alternative is ZDV monotherapy initiated between 20 and 28 weeks, given orally, 250 mg twice daily, and intravenously started four hours before beginning the Caesarean section, continuing until the umbilical cord has been clamped. ZDV is usually administered orally to the neonate for four to six weeks.
    Combination antiretroviral therapy maximises the chance of preventing transmission and represents optimal therapy for the mother but may increase the risk of drug toxicity to the fetus.
    The use of antiretrovirals to reduce MTCT has resulted in resistant mutations and, in the Paediatric AIDS Clinical Trials Group Protocol, 15% of the women developed nevirapine-resistant mutations by 6 weeks' postpartum.

In sub-Saharan Africa, access to services is improving. In 2008, 45% of HIV-infected pregnant women received antiretroviral treatment compared with 9% in 2004. 

Prevention of Viral Diseases

   Viral diseases are among those which spread from one person to another. Illness develops when a virus enters the body, invades healthy cells and replicates itself. At times, a virus can mutate itself during the replication process, making it more difficult for the body to fight. Viruses depend on other living organisms to survive and are hard to remove once in the body. Few medications fight viruses, making the body's immune system the best protection against infection.

    Viruses range in severity, making some life threatening conditions. Viruses have several groups in which they are categorized based on shape, behaviors and other common characteristics. For instance, the picornaviruses group includes the rhino-viruses which cause the common cold, or the papovaviruses which includes the papilloma virus known to women as HPV. More serious viruses such as HIV and Hepatitis C fall into groups of viruses known to generate their own DNA, enabling them to replicate themselves repeatedly within the body.

    Transmission
    Viruses are transmitted from one person to another through touching, breathing, bites and contact with body fluids (saliva, blood, semen or excrement). The most common form of transmission is by inhaling droplets of a virus in the air you breathe. Shared objects such as spoons, cups, door knobs and pencils that have been exposed can carry droplets of a virus from person to person. Insects and animals can transmit viruses by biting a human or another animal.
    Direct contact with body fluids can cause virus transmission, but only when certain conditions are met. Direct contact requires a significant amount of body fluid to be present, the person to have direct contact with the fluid, have a point of entry for the virus to enter into the body (cuts, scrapes, eyes, mouth) and be susceptible to the virus.

    Effects
    Viruses cause illness and discomfort for the sufferer, many of them are often temporary and usually non-life threatening. Effects of viruses can include symptoms such as dehydration, nausea, vomiting, high fever and weakness. Viruses such as Influenza cannot be cured with medication, but their effects can be kept under control until it finally disappears.
    Viruses, such as strains of Hepatitis, HIV and herpes, do not disappear. Their effects are felt throughout a lifetime for the person infected, sometimes resulting in death.

    Prevention
    Following simple steps can greatly reduce the risk of contracting a virus. Use bandages to cover scrapes, cuts or open sores at all times. Do not eat, drink, touch your mouth, nose or eyes before washing your hands and avoid handling pens, pencils or other items that belong to others. Never drink from someone else's beverage containers or eat from another persons soiled utensils. Frequent hand washing is highly recommended with soap and warm running water or an alcohol based sanitizing hand gel.

    Cleaning
    Bleach based products are extremely effective in killing 99.9% of germs and viruses in, and around, the home. If the cost of bleach based cleansers is an issue, 1 1/2 cups of chlorine bleach to a gallon of fresh water will clean with the same effectiveness. You may add a few drops of dish detergent to the mixture for a soapy consistency.
    Regular cleaning is recommended for door handles, bathroom sinks, toilets and toothbrush holders in an effort to reduce the chances of contracting a strain of flu or the common cold.

Primary Immunodeficiency Diseases

One of the most important functions of the immune system is to protect us from bacteria, viruses, and fungi that can make us sick. Not all organisms are harmful--in fact, our intestines contain many bacteria that help prevent problems such as allergies and improper absorption of nutrients. The immune system identifies the difference between what is dangerous and what is not and prevents whatever is dangerous from harming us. Primary immunodeficiency diseases (PIDDs) are caused by mutations in genes that prevent the body from developing normal immune responses to infectious challenges. The mutations can either be inherited or appear randomly.  Because the immune system is compromised in PIDDs, harmful organisms usually cause recurrent and sometimes life-threatening infections.  In addition, since these diseases are genetic, they are generally considered to be lifelong conditions once they are diagnosed.

How common are primary immunodeficiency diseases?

The most common PIDD is selective IgA deficiency, which has been reported as frequently as about one in every 300 to 400 individuals in the United States.  Although other PIDDs may occur less frequently, the actual rates of occurrence are not known because positive diagnoses are often not made.  As screening of newborns for important PIDDs becomes implemented as a standard practice, these statistics should become more accurate.

What are the signs and symptoms of primary immunodeficiency diseases?

Signs and symptoms that often alert us of the possibility of a PIDD are well-summarized by the following "10 Warning Signs of Primary Immunodeficiency":

    Four or more new ear infections within one year, particularly after the first year of life.
    Two or more serious sinus infections within one year.
    Two or more months on antibiotics with little effect.
    Two or more pneumonias within one year.
    Failure of an infant to gain weight or grow normally.
    Recurrent, deep skin or organ abscesses.
    Persistent thrush in the mouth or significant fungal infections on the skin.
    Need for intravenous antibiotics to clear infections.
    Two or more deep-seated infections, including infections of the bloodstream.
    A family history of primary immune deficiency.

How are primary immunodeficiency diseases treated?

Our patients are often given antibiotics or antifungal medications for prevention or treatment of infections. These medications need to be prescribed carefully because they can sometimes cause unwanted side effects or encourage the growth of bacteria that are resistant to antibiotics. Patients who lack the ability to make antibodies often require immunoglobulin replacement therapy.  Some patients, depending on the type of PIDD that has been diagnosed, may require bone marrow or umbilical cord stem cell transplantation or even thymus transplantation in the most severe cases. Sometimes it may be treated with anabolic steroids.

How are Viral Diseases Treated?

Viral diseases are extremely widespread infections caused by viruses, a type of microorganism. There are many types of viruses that cause a wide variety of viral diseases. The most common type of viral disease is the common cold, which is caused by a viral infection of the upper respiratory tract.

Treatment of viral infections varies depending on the specific virus and other factors. General treatment measures are aimed at relieving your symptoms so that you can get the rest you need to keep up your strength and recover without developing complications.

General treatments for viral infections include:

    Acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) for fever, body aches, and pain

    Drinking extra fluids

    Getting extra rest and sleep

    Maintaining good nutrition

Depending on the type of viral infection and the presence of complications, a wide variety of other treatments may be needed. For example, a human papillomavirus (HPV) infection that leads to cervical dysplasia can be treated by surgical removal of the abnormal cells on a woman’s cervix.  

In general, it is recommended that children younger than age six not use cold or cough medications because of the risk for serious side effects. In addition, people with a viral disease should not use aspirin or products that contain aspirin because of the risk of developing a rare but life-threatening condition called Reye syndrome. Reye syndrome has been linked to taking aspirin during a viral illness, such as a cold or the flu.