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Antivirals - When, How and Where?

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Dr Ritabrata Kundu, Kolkata    15 January 2018

  1. The antiviral chemotherapy for the treatment of common viral infections is faced with many challenges such as intracellular replication of the virus the decision to start antiviral therapy in respiratory infections, such as flu, should not wait for lab confirmation.
  2. Antiviral treatment for patients with suspected or confirmed flu is only recommended in case of hospitalized patients, with severe, complicated or progressive illness and those with higher risk of complications.
  3. Antiviral therapy is not recommended in case of acute hepatitis while treatment is only recommended in immuneactive form of chronic hepatitis.
  4. In case of Herpes simplex encephalitis, 3 antiviral drugs are available in India: acyclovir, valacyclovir and famciclovir.
  5. In case of neonatal HSV, acyclovir use is recommended.
  6. As per the recommendation of AAP, uncomplicated varicella in a healthy child should not be given treatment. In immunocompetent persons at increased risk of moderate to severe varicella, acyclovir is recommended.
  7. Infants born to mother with varicella, preterm <28 weeks or <1 kg exposed to varicella should be treated with VZIG/IVIG.

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