What effective treatments exist for any viral disease?

[lljkk]

I have impression there might be very very few. Maybe even none.
This seems to say the same.

Things like organ support, analgesic, antibiotics to deal with secondary infections, fluids help... but all of that is just waiting for the immune system to actually fight a virus off. Only a person's body can do this.

Am I wrong? What really good drug or treatment exists that isn't just buying time for the patient?

tamiflu for swine flu.
HIV drugs, people on treatment in the West can have a natural lifespan even while being HIV positive.

Not technically curing it (at least in the case of HIV medication), but very effective treatments.

There are very effective antiretroviral drugs for HIV. They have turned AIDS from what was often a fatal disease into a very managable one.

www.todayonline.com/world/scientists-china-believe-new-drug-can-stop-pandemic-without-vaccine

This article provides some interesting background but yes hiv and Ebola seem to have some treatments and these are being used as a basis to develop covid treatments. Early days but could be hopeful!

This Tamiflu?

Acyclovir Is literally my saviour!
I get appalling cold sore outbreaks due to reactivation of the herpes simplex virus.
So for me this is a fab one.

Hepatitis B has several treatments (tenofovir is the one I’m familiar with).

It’s my understanding that antivirals, including HIV treatments, don’t so much cure the virus but reduce its load number so it’s not detectable and much less likely to transmit. Happy to be corrected on that though.

I don’t know how that would translate to Covid though. Presumably it’s not showing itself to be a virus that we’d have to live with as a long term condition the same way HIV and hepatitis’ are.

Good point about HIV, though, that is a miracle story, even if it is a life long and complicated drug regime. And some of the Ebola treatments are good. The Ebola drugs only took, what... 5 or 45 yrs to find, though, right?

Oh, and again I’m regurgitating information from people much cleverer than I am but HIV infects by a different mechanism so is much harder to develop treatments and vaccines for. As I understand it HIV tends to hide inside a certain type of cell and cause issues there. I think coronaviruses are spikey obvious bastards which may make them easier to detect and target.

So... tenofovir is another drug that doesn't cure the virus (HepB) but does reduce harm & onward transmission, right? And may not need to take it for life.

My instinct on it is that viruses are often fairly mild for the majority and so don’t warrant specific treatment. Others have more significant effects but we have generally been able to develop vaccines against those (measles, mumps etc) so they have very low prevalence in the community.

The ones we haven’t developed vaccines for thus far fall into two camps. 1 - self limiting, low prevalence diseases (SARS etc) or 2 - very difficult to vaccinate against (HIV Etc)

HIV now has very effective treatments so I think it very likely that if COVID falls into the same camp as HIV we will find good and effective treatments for it. My gut instinct though is that we will find a vaccine for COVID in the short to medium term although obviously we wouldn’t want to put all our eggs in that basket .

I’m not an an expert @lljkk but I think that’s the case although I think HIV drugs tend to be taken lifelong. Maybe the difference is we know that people are recovering independently so any drug therapy would be supporting that.

You have prompted me to google pre-exposure prophylaxis’s though. I’m vaguely aware treatment can be given for HIV if there has been a high risk exposure (needle stick injury, sexual assault) and rabies. I think they’re pretty brutal in terms of side effects though

@Cornettoninja that's post-exposure prophylaxis (PEP), as you say generally given to HCPs who have had a needlestick, or after risky sexual contact. Pre-exposure prophylaxis (PrEP) is a daily tablet taken by people who are in a high risk group. Similar to the distinction between the morning after pill and the contraceptive pill I suppose.

@lljkk hepatitis C can now be cured through a combination of antivirals. There are effective treatments out there. Zanamivir is another treatment for flu if oseltamivir (Tamiflu) isn't working. So it's not correct that the body has to fight off viruses, pharmacological treatments can and do help.

Off the top of my head, there are effective antivirals for HIV, hep B, hep C, herpes group viruses. Also ones that are semi-effective or have some use in specific circumstances for flu and RSV. A couple of investigational drugs for Ebola.

Viruses aren’t truly living organisms, eg like bacteria. They can’t replicate without using the host cell mechanisms. This makes it much harder to find drugs that kill the virus without also killing the host, or having nasty side effects.

Thanks @ashmts. It’s really interesting and reassuring to see what’s been achieved in other diseases. All adds to the foundation for scientists to build on to tackle Covid I suppose.

Some really good into on here regarding HIV - PrEP and PEP (both very well tolerated btw), effective treatment, normal lifespan etc. Just to address a few points and add a few things generally...

The main aim of HIV treatment is to suppress the virus to the point that it no longer impacts on our immune system. the knock on effect is that is can't be passed on to any partners.

My understanding is that viruses tend to enter the body in a similar way -via spike receptors specific to each one on the host cell's surface. HIV is a different kind of virus to coronavirus, in that it is a retrovirus. It enters CD4 cells (a type of white blood cell that usually protects us) and integrates itself into our DNA, basically using our own immune system against us. It then makes more copies of itself, then exiting to repeat the process leaving the CD4 to die. Where it differs to coronavirus is a lot of copies of HIV then lie dormant in various parts of the body - apparently up to 60 years. While treatment very effectively dispatches those that "wake up" by not allowing them to reproduce. This is why a cure has been so difficult to find and the only people who have been cured underwent extensive, expensive and very dangerous cancer treatment that literally wiped their immune system which had the effect of wiping out the HIV too. Coronavirus does not have this mechanism of lying dormant in the body after it's been contracted.

Re Hepatitis - both A & B, where contracted, normally gets cleared by the body's own immune system. Tenofovir (also an antiretroviral used in HIV treatment, PrEP & PEP) is used where the body is unable to clear it and it becomes acute.

Antibodies are not always made by the body after immunisation is administered. When I was diagnosed with HIV I had various blood tests that showed up antibodies to various childhood illnesses and past vaccinations - Hep A that I'd had done before travelling abroad over 25 years previously for example. I was offered the Hepatitis B jab (a set of 3) which I accepted, but had it explained to me that in older people vaccinations generally might not create antibodies - ie won't give protection. This is due to immune systems generally in people getting older. However I had a test done. After completing the course which showed I did in fact have antibodies. You might be aware that there is a different flu jab for older people - trivalent as opposed to quadrivalent - as it might take better.

Sorry, I've rambled. I'll finish by saying there's so many studies being done and great that a treatment for something might be effective for something else. The only worthwhile ones to watch are those already being tested on people and well on in the process. This is looking promising - remdesivir. It's very rare that a study is shut early but in this case it has proven effective so the ethical thing to do it allow those on the placebo to take it too if needed. i-base.info/htb/37976

@HIVpos - thanks for your post, it was really interesting