Correlation seminar:

Infective Hepatitis
Name of presenter: Suyog R. Gautam
Objective 10
● List the drugs used in the treatment of infective hepatitis along with their
pharmacological basis.
Drugs used against Hepatitis virus
Classification
Drugs against Hepatitis B Prodrug: disoproxil
ester
1. Tenofovir
Tenofovir is one of the first line drugs for chronic hepatitis
Tenofovir released by hydrolysis and is
due to HBV as diphosphorylated by cellular kinases

It has: high efficacy,

good tolerability and tenofovir diphosphate

low risk of resistance

Effective in lamivudine resistant HBV cases.
● inhibits HBV-DNA polymerase
● Affinity for host DNA-polymerase is
very low
● It also gets incorporated in the viral
DNA to cause chain termination
Lamivudine: Lamivudine

● It is the first line drug for chronic

Hepatitis B. phosphorylation by host cellular enzyme
● Its systemic toxicity is low

triphosphate(active form)

inhibits HBV DNA polymerase

Entecavir
Entecavir
● It is currently the most active
and 1st line drug for chronic
hepatitis B. phosphorylation to triphosphate

● well sustained and HBV-

resistance to entecavir is rare competes with natural substrate deoxy GTP
upto 5 years of use
● It is well tolerated drug.
for viral reverse transcriptase
Drugs against Hepatitis C

The basis of treatment for chronic hepC is to attain sustained viral response (SVR), ie
undetectable HCV-RNA in blood for at least 6 months after completion of therapy
 Ribavirin
Ribavirin
ribavirin monophosphate
● purine nucleoside analogue has broad-
spectrum antiviral activity, including that
against HCV
ribavirin triphosphate
● Viral resistance to ribavirin is rare

prevents viral mRNA

● Used in chronic hepatitis C Capping synthesis inhibits
GTP

no RNA synthesis
Interferon alpha
Interferon alpha
● They are cytokine produced by host cells in
response to viral infections.

Inhibits viral RNA translation

● It is complexed with polyethylene glycol

which causes sustained effect
Degradation of viral mRNA and tRNA
 New direct acting anti-HCV drugs

NS5B POLYMERASE INHIBITOR: SOFOSBUVIR

NS3/4A PROTEASE INHIBITOR: SIMEPREVIR

NS5A INHIBITOR: DACLATASVIR, LEDIPASVIR, VELPATASVIR

summary
Reference

● Essential of medical pharmacology(8th edition)

● Lippincott’s illustrated reviews (4th edition)
THANK YOU