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Chapter 44: Antiviral Agents and Treatment of HIV Infection

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A 48-year-old man with AIDS is diagnosed with CMV retinitis. He is being treated with intravenous foscarnet. A laboratory blood test for which of the following should be monitored closely?

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a. Copper

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b. Alanine aminotransferase

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c. Calcium

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d. Zinc

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e. Bilirubin

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Answer is c. Foscarnet is highly ionized at physiological pH, and metabolic abnormalities are common. These include increases or decreases in calcium and phosphate, hypomagnesemia, and hypokalemia. Decreased serum ionized calcium may cause paresthesia, arrhythmias, tetany, seizures, and other CNS disturbances. Concomitant intravenous pentamidine administration increases the risk of symptomatic hypocalcemia.

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Which of the following drugs is an option for the treatment of CMV retinitis in the patient in Question 44-1?

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a. Acyclovir

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b. Gancyclovir

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c. Rimantadine

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d. Oseltamivir

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e. Ribavirin

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Answer is b. Acyclovir is ineffective therapeutically in established CMV infections, but gancyclovir is effective for treatment and chronic suppression of CMV retinitis in immunocompromised patients and for prevention of CMV in transplant patients.

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A 36-year-old woman has been diagnosed with chronic hepatitis C. She is prescribed oral ribavirin in combination with which of the following agents for her treatment?

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a. Tenofovir

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b. Telbivudine

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c. Enfuvirtide

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d. PegINF alpha-2A

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e. Cidofovir

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Answer is d. Oral ribavirin in combination with injected pegINF alfa-2A or -2B has become standard treatment for chronic HCV infection.

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A 27-year-old man with newly diagnosed HIV infection is started on zidovudine alone. This treatment regimen is unlikely to be therapeutically effective because

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a. zidovudine is not active against HIV.

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b. zidovudine is metabolized by hepatic CYPs.

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c. the side effects of zidovudine do not warrant its use.

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d. the use of zidovudine is limited by its absorption from the gastrointestinal tract.

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e. resistance of the HIV is likely to develop from the use of a single agent.

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Answer is e. Starting treatment with only ...

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