1.In Silico Screening of Natural Products as Potential Inhibitors of SARS-CoV-2 Using Molecular Docking Simulation.
Rajib HOSSAIN ; Chandan SARKAR ; Shardar Mohammad Hafiz HASSAN ; Rasel Ahmed KHAN ; Mohammad ARMAN ; Pranta RAY ; Muhammad Torequl ISLAM ; Sevgi Durna DAŞTAN ; Javad SHARIFI-RAD ; Zainab M ALMARHOON ; Miquel MARTORELL ; William N SETZER ; Daniela CALINA
Chinese journal of integrative medicine 2022;28(3):249-256
OBJECTIVE:
To explore potential natural products against severe acute respiratory syndrome coronavirus (SARS-CoV-2) via the study of structural and non-structural proteins of human coronaviruses.
METHODS:
In this study, we performed an in-silico survey of 25 potential natural compounds acting against SARS-CoV-2. Molecular docking studies were carried out using compounds against 3-chymotrypsin-like protease (3CLPRO), papain-like protease (PLPRO), RNA-dependent RNA polymerase (RdRp), non-structural protein (nsp), human angiotensin converting enzyme 2 receptor (hACE2R), spike glycoprotein (S protein), abelson murine leukemia viral oncogene homolog 1 (ABL1), calcineurin-nuclear factor of activated T-cells (NFAT) and transmembrane protease serine 2.
RESULTS:
Among the screened compounds, amentoflavone showed the best binding affinity with the 3CLPRO, RdRp, nsp13, nsp15, hACE2R. ABL1 and calcineurin-NFAT; berbamine with hACE2R and ABL1; cepharanthine with nsp10, nsp14, nsp16, S protein and ABL1; glucogallin with nsp15; and papyriflavonol A with PLPRO protein. Other good interacting compounds were juglanin, betulinic acid, betulonic acid, broussooflavan A, tomentin A, B and E, 7-methoxycryptopleurine, aloe emodin, quercetin, tanshinone I, tylophorine and furruginol, which also showed excellent binding affinity towards a number of target proteins. Most of these compounds showed better binding affinities towards the target proteins than the standard drugs used in this study.
CONCLUSION
Natural products or their derivatives may be one of the potential targets to fight against SARS-CoV-2.
Animals
;
Antiviral Agents/therapeutic use*
;
Biological Products/pharmacology*
;
COVID-19/drug therapy*
;
Humans
;
Mice
;
Molecular Docking Simulation
;
SARS-CoV-2
2.Anti-herpes simplex virus type Ⅰ of tectorigenin derivative and effect on Toll-like receptors in vitro.
Yuan WANG ; Ming-Ming YUAN ; Jing ZHOU ; Xiao-Han ZHENG ; Chong-Jun YUAN ; Shuai CHEN ; Sen LUO ; Lei ZHANG
China Journal of Chinese Materia Medica 2022;47(16):4428-4435
The study investigated the inhibitory effect and mechanism of tectorigenin derivative(SGY) against herpes simplex virus type Ⅰ(HSV-1) by in vitro experiments. The cytotoxicity of SGY and positive drug acyclovir(ACV) on African green monkey kidney(Vero) cells and mouse microglia(BV-2) cells was detected by cell counting kit-8(CCK-8) method, and the maximum non-toxic concentration and median toxic concentration(TC_(50)) of the drugs were calculated. After Vero cells were infected with HSV-1, the virulence was determined by cytopathologic effects(CPE) to calculate viral titers. The inhibitory effect of the tested drugs on HSV-1-induced cytopathy in Vero cells was measured, and their modes of action were initially explored by virus adsorption, replication and inactivation. The effects of the drugs on viral load of BV-2 cells 24 h after HSV-1 infection and the Toll-like receptor(TLR) mRNA expression were detected by real-time fluorescence quantitative PCR(RT-qPCR). The maximum non-toxic concentrations of SGY against Vero and BV-2 cells were 382.804 μg·mL~(-1) and 251.78 μg·mL~(-1), respectively, and TC_(50) was 1 749.98 μg·mL~(-1) and 2 977.50 μg·mL~(-1), respectively. In Vero cell model, the half maximal inhibitory concentration(IC_(50)) of SGY against HSV-1 was 54.49 μg·mL~(-1), and the selection index(SI) was 32.12, with the mode of action of significantly inhibiting replication and directly inactivating HSV-1. RT-qPCR results showed that SGY markedly reduced the viral load in cells. The virus model group had significantly increased relative expression of TLR2, TLR3 and tumor necrosis factor receptor-associated factor 3(TRAF3) and reduced relative expression of TLR9 as compared with normal group, and after SGY intervention, the expression of TLR2, TLR3 and TRAF3 was decreased to different degrees and that of TLR9 was enhanced. The expression of inflammatory factors inducible nitric oxide synthase(iNOS), tumor necrosis factor-α(TNF-α), and interleukin-1β(IL-1β) was remarkably increased in virus model group as compared with that in normal group, and the levels of these inflammatory factors dropped after SGY intervention. In conclusion, SGY significantly inhibited and directly inactivated HSV-1 in vitro. In addition, it modulated the expression of TLR2, TLR3 and TLR9 related pathways, and suppressed the increase of inflammatory factor levels.
Animals
;
Antiviral Agents/therapeutic use*
;
Chlorocebus aethiops
;
Herpes Simplex/pathology*
;
Herpesvirus 1, Human/metabolism*
;
Isoflavones
;
Mice
;
TNF Receptor-Associated Factor 3/pharmacology*
;
Toll-Like Receptor 2/metabolism*
;
Toll-Like Receptor 3/metabolism*
;
Toll-Like Receptor 9/metabolism*
;
Toll-Like Receptors/metabolism*
;
Tumor Necrosis Factor-alpha/metabolism*
;
Vero Cells
;
Virus Replication
3.Traditional Uses, Phytochemistry, Pharmacology and Toxicology of Rhizoma phragmitis: A Narrative Review.
Yuan REN ; Ge-Dan CUI ; Li-Sha HE ; Huan YAO ; Chang-Yan ZI ; Yong-Xiang GAO
Chinese journal of integrative medicine 2022;28(12):1127-1136
Rhizoma phragmitis is a common Chinese herbal medicine whose effects are defined as 'clearing heat and fire, promoting fluid production to quench thirst, eliminating irritability, stopping vomiting, and disinhibiting urine'. During the Novel Coronavirus epidemic in 2020, the Weijing Decoction and Wuye Lugen Decoction, with Rhizoma phragmitis as the main herbal component, were included in The Pneumonia Treatment Protocol for Novel Coronavirus Infection (Trial Version 5) due to remarkable antiviral effects. Modern pharmacological studies have shown that Rhizoma phragmitis has antiviral, antioxidative, anti-inflammatory, analgesic, and hypoglycemic functions, lowers blood lipids and protects the liver and kidney. This review aims to provide a systematic summary of the botany, traditional applications, phytochemistry, pharmacology and toxicology of Rhizoma phragmitis.
Humans
;
Plant Extracts/pharmacology*
;
Rhizome
;
Drugs, Chinese Herbal/therapeutic use*
;
Antioxidants/therapeutic use*
;
Antiviral Agents/therapeutic use*
;
Medicine, Chinese Traditional
;
Phytochemicals/therapeutic use*
;
Ethnopharmacology
;
COVID-19 Drug Treatment
4.Role of cyclophilin A during coronavirus replication and the antiviral activities of its inhibitors.
Lu TIAN ; Wenjun LIU ; Lei SUN
Chinese Journal of Biotechnology 2020;36(4):605-611
Cyclophilin A (CypA) is a widely distributed and highly conserved protein in organisms. It has peptidyl-prolyl cis/trans isomerase activity and is a receptor for cyclosporin A (CsA). Coronaviruses are enveloped, single-stranded, positive-sense RNA viruses. Seven types of coronaviruses are currently known to infect humans, among which SARS-CoV, MERS-CoV, and SARS-CoV-2 are fatal for humans. It is well established that CypA is essential for the replication of various coronaviruses such as SARS-CoV, CoV-229E, CoV-NL63, and FCoV. Additionally, CsA and its derivatives (ALV, NIM811, etc.) have obvious inhibitory effects on a variety of coronaviruses. These results suggest that CypA is a potential antiviral target and the existing drug CsA might be used as an anti-coronavirus drug. At the end of 2019, SARS-CoV-2 raged in China, which seriously theatern human health and causes huge economic lases. In view of this, we describe the effects of CypA on the replication of coronaviruses and the antiviral activities of its inhibitors, which will provide the scientific basis and ideas for the development of antiviral drugs for SARS-CoV-2.
Antiviral Agents
;
pharmacology
;
therapeutic use
;
Betacoronavirus
;
drug effects
;
growth & development
;
Coronavirus
;
drug effects
;
growth & development
;
Coronavirus Infections
;
drug therapy
;
epidemiology
;
virology
;
Cyclophilin A
;
antagonists & inhibitors
;
Cyclosporine
;
chemistry
;
pharmacology
;
therapeutic use
;
Humans
;
Pandemics
;
Pneumonia, Viral
;
drug therapy
;
epidemiology
;
virology
;
SARS Virus
;
drug effects
;
growth & development
;
Virus Replication
;
drug effects
5.Diagnosis, treatment, control and prevention of SARS-CoV-2 and coronavirus disease 2019: back to the future.
Chinese Journal of Biotechnology 2020;36(4):571-592
The ongoing outbreak of the coronavirus disease 2019 (COVID-19) as named by the World Health Organization has millions of confirmed cases around the world and has claimed hundreds of thousands of lives. The virus was named SARS-CoV-2 in February by International Committee on Taxonomy of Viruses. COVID-19 presents as fever, dry cough, dyspnea, headache and pneumonia. In a small subset of severe cases, the disease quickly progresses to respiratory failure and even death. Since the 21st century, there have been three major outbreaks caused by human coronaviruses, including the severe acute respiratory syndrome (SARS) that broke out in 2003, the Middle East respiratory syndrome (MERS) in 2012, and the recent pandemic of COVID-19. Since 2003, significant progress has been made in the study of SARS-CoV and MERS-CoV concerning their natural origins, pathogenesis, antiviral development and vaccine design. Since SARS-CoV-2 and SARS-CoV are closely related, previous findings on SARS-CoV are highly relevant to a better understanding as well as diagnosis, treatment, prevention and control of SARS-CoV-2. In this review, we highlight recent progresses in the field; compare the biological characteristics of SARS-CoV and SARS-CoV-2; summarize the urgently-needed diagnostic, treatment, prevention and control options; and provide future perspectives for the outcome of the outbreak and research questions to be answered, including some of the difficulties in vaccine development. Hopefully, our comments and suggestions would prove useful for the control of the SARS-CoV-2 epidemic in China and the world.
Antiviral Agents
;
pharmacology
;
therapeutic use
;
Betacoronavirus
;
drug effects
;
immunology
;
pathogenicity
;
Coronavirus Infections
;
diagnosis
;
prevention & control
;
therapy
;
virology
;
Humans
;
Middle East Respiratory Syndrome Coronavirus
;
drug effects
;
immunology
;
pathogenicity
;
Pandemics
;
prevention & control
;
Pneumonia, Viral
;
diagnosis
;
prevention & control
;
therapy
;
virology
;
SARS Virus
;
drug effects
;
immunology
;
pathogenicity
;
Severe Acute Respiratory Syndrome
;
diagnosis
;
prevention & control
;
therapy
;
virology
;
Viral Vaccines
6.Novel and potent inhibitors targeting DHODH are broad-spectrum antivirals against RNA viruses including newly-emerged coronavirus SARS-CoV-2.
Rui XIONG ; Leike ZHANG ; Shiliang LI ; Yuan SUN ; Minyi DING ; Yong WANG ; Yongliang ZHAO ; Yan WU ; Weijuan SHANG ; Xiaming JIANG ; Jiwei SHAN ; Zihao SHEN ; Yi TONG ; Liuxin XU ; Yu CHEN ; Yingle LIU ; Gang ZOU ; Dimitri LAVILLETE ; Zhenjiang ZHAO ; Rui WANG ; Lili ZHU ; Gengfu XIAO ; Ke LAN ; Honglin LI ; Ke XU
Protein & Cell 2020;11(10):723-739
Emerging and re-emerging RNA viruses occasionally cause epidemics and pandemics worldwide, such as the on-going outbreak of the novel coronavirus SARS-CoV-2. Herein, we identified two potent inhibitors of human DHODH, S312 and S416, with favorable drug-likeness and pharmacokinetic profiles, which all showed broad-spectrum antiviral effects against various RNA viruses, including influenza A virus, Zika virus, Ebola virus, and particularly against SARS-CoV-2. Notably, S416 is reported to be the most potent inhibitor so far with an EC of 17 nmol/L and an SI value of 10,505.88 in infected cells. Our results are the first to validate that DHODH is an attractive host target through high antiviral efficacy in vivo and low virus replication in DHODH knock-out cells. This work demonstrates that both S312/S416 and old drugs (Leflunomide/Teriflunomide) with dual actions of antiviral and immuno-regulation may have clinical potentials to cure SARS-CoV-2 or other RNA viruses circulating worldwide, no matter such viruses are mutated or not.
Animals
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Antiviral Agents
;
pharmacology
;
therapeutic use
;
Betacoronavirus
;
drug effects
;
physiology
;
Binding Sites
;
drug effects
;
Cell Line
;
Coronavirus Infections
;
drug therapy
;
virology
;
Crotonates
;
pharmacology
;
Cytokine Release Syndrome
;
drug therapy
;
Drug Evaluation, Preclinical
;
Gene Knockout Techniques
;
Humans
;
Influenza A virus
;
drug effects
;
Leflunomide
;
pharmacology
;
Mice
;
Mice, Inbred BALB C
;
Orthomyxoviridae Infections
;
drug therapy
;
Oseltamivir
;
therapeutic use
;
Oxidoreductases
;
antagonists & inhibitors
;
metabolism
;
Pandemics
;
Pneumonia, Viral
;
drug therapy
;
virology
;
Protein Binding
;
drug effects
;
Pyrimidines
;
biosynthesis
;
RNA Viruses
;
drug effects
;
physiology
;
Structure-Activity Relationship
;
Toluidines
;
pharmacology
;
Ubiquinone
;
metabolism
;
Virus Replication
;
drug effects
7.Comparison of the clinical outcomes between antiviral-naïve patients treated with entecavir and lamivudine-resistant patients receiving adefovir add-on lamivudine combination treatment.
Hong Joo KIM ; Soo Kyung PARK ; Hyo Joon YANG ; Yoon Suk JUNG ; Jung Ho PARK ; Dong Il PARK ; Yong Kyun CHO ; Chong Il SOHN ; Woo Kyu JEON ; Byung Ik KIM ; Kyu Yong CHOI
Clinical and Molecular Hepatology 2016;22(3):350-358
BACKGROUND/AIMS: To analyze the effects of preexisting lamivudine (LAM) resistance and applying antiviral treatment (adefovir [ADV] add-on LAM combination treatment) on long-term treatment outcomes, and comparing the clinical outcomes of antiviral-naïve chronic hepatitis B patients receiving entecavir (ETV) monotherapy. METHODS: This study enrolled 73 antiviral-naïve patients who received 0.5-mg ETV as an initial therapy and 54 patients who received ADV add-on LAM combination treatment as a rescue therapy from July 2006 to July 2010. RESULTS: During 24-month treatments, the decreases in serum log10HBV-DNA values (copies/mL) were significantly greater in the antiviral-naïve patients treated with ETV than the patients receiving ADV add-on LAM combination treatment. The biochemical response rates for alanine aminotransferase normalization at 6 months (ETV) and 12 months (ADV add-on LAM) were 90.4% (66/73) and 77.8% (42/54), respectively (P=0.048). A Kaplan-Meier analysis indicated that the rates of serologic response, viral breakthrough, and emergence of genotypic resistance did not differ significantly between the two patient groups. There were also no significant intergroup differences in the rates of disease progression (PD) and new development of hepatocellular carcinoma (HCC). CONCLUSION: The long-term clinical outcomes of antiviral-naïve patients treated with ETV and LAM-resistant patients receiving ADV add-on LAM combination treatment were comparable in terms of the emergence of HCC and disease progression.
Adenine/*analogs & derivatives/pharmacology/therapeutic use
;
Adult
;
Alanine Transaminase/blood
;
Antibodies, Viral/blood
;
Antiviral Agents/*therapeutic use
;
DNA, Viral/blood
;
Disease Progression
;
Drug Resistance, Viral/drug effects
;
Drug Therapy, Combination
;
Female
;
Follow-Up Studies
;
Genotype
;
Guanine/analogs & derivatives/pharmacology/therapeutic use
;
Hepatitis B e Antigens/blood
;
Hepatitis B virus/drug effects/genetics/isolation & purification
;
Hepatitis B, Chronic/*drug therapy
;
Humans
;
Lamivudine/pharmacology/therapeutic use
;
Male
;
Middle Aged
;
Organophosphonates/pharmacology/*therapeutic use
;
Treatment Outcome
8.Comparison of tenofovir plus lamivudine versus tenofovir monotherapy in patients with lamivudine-resistant chronic hepatitis B.
Chan Ho PARK ; Seok Won JUNG ; Jung Woo SHIN ; Mi Ae BAE ; Yoon Im LEE ; Yong Tae PARK ; Hwa Sik CHUNG ; Neung Hwa PARK
Clinical and Molecular Hepatology 2016;22(1):152-159
BACKGROUND/AIMS: Tenofovir disoproxil fumarate (TDF) exhibits similar antiviral efficacy against treatment-naïve and lamivudine (LAM)-resistant chronic hepatitis B (CHB). However, there are few clinical reports on the antiviral effects of TDF-LAM combination therapy compared to TDF monotherapy in patients with LAM-resistant CHB. METHODS: We investigated the antiviral efficacy of TDF monotherapy vs. TDF-LAM combination therapy in 103 patients with LAM-resistant CHB. RESULTS: The study subjects were treated with TDF alone (n=40) or TDF-LAM combination therapy (n=63) for ≥6 months. The patients had previously been treated with TDF-based rescue therapy for a median of 30.0 months (range, 8-36 months). A virologic response (VR) was achieved in 99 patients (96.1%): 95.0% (38/40) of patients in the TDF monotherapy group and 96.8% (61/63) of patients in the TDF-LAM combination therapy group. The VR rates were not significantly different between the TDF monotherapy and TDF-LAM combination therapy groups (88.9 vs. 87.3% at month 12, and 94.4 vs. 93.7% at month 24, log-rank p=0.652). Univariate and multivariate analyses revealed that none of the pretreatment factors were significantly associated with VR. CONCLUSIONS: TDF monotherapy was as effective as TDF-LAM combination therapy for maintaining viral suppression in the vast majority of patients with LAM-resistant CHB, which suggests that TDF add-on therapy with LAM is unnecessary.
Adult
;
Aged
;
Aged, 80 and over
;
Antiviral Agents/pharmacology/*therapeutic use
;
DNA, Viral/blood
;
Drug Administration Schedule
;
Drug Resistance, Viral/drug effects
;
Drug Therapy, Combination
;
Female
;
Hepatitis B virus/genetics
;
Hepatitis B, Chronic/*drug therapy
;
Humans
;
Kidney Function Tests
;
Lamivudine/*therapeutic use
;
Liver Function Tests
;
Male
;
Middle Aged
;
Polymerase Chain Reaction
;
Tenofovir/*therapeutic use
;
Treatment Outcome
9.Efficacy of Tenofovir-based Rescue Therapy for Patients with Drug-resistant Chronic Hepatitis B.
Kanghyug CHOI ; Han Min LEE ; Baek Gyu JUN ; Sae Hwan LEE ; Hong Soo KIM ; Sang Gyune KIM ; Young Seok KIM ; Boo Sung KIM ; Soung Won JEONG ; Jae Young JANG ; Young Don KIM ; Gab Jin CHEON
The Korean Journal of Gastroenterology 2015;65(1):35-42
BACKGROUND/AIMS: Tenofovir disoproxil fumarate (TDF) plays a pivotal role in the management of drug-resistant chronic hepatitis B. However, it remains unclear whether TDF-nucleoside analogue combination therapy provides better outcomes than TDF monotherapy. This study aimed to compare the efficacy of TDF monotherapy with that of TDF-nucleoside analogue combination therapy in patients with drug-resistant chronic hepatitis B. METHODS: This retrospective cohort study included 76 patients receiving TDF-based rescue therapy for more than 12 months. Suboptimal response was defined as serum HBV-DNA level of >60 IU/mL during prior rescue therapy. Multi-drug resistance was defined as the presence of two or more drug resistance-related mutations confirmed by mutation detection assay. The relationship between baseline characteristics and virologic response (HBV DNA <20 IU/mL) at 12 months were evaluated using logistic regression analysis. RESULTS: Fifty-five patients (72.4%) were suboptimal responders to prior rescue therapy, and 26 (34.2%) had multi-drug resistance. Forty-two patients (55.3%) received combination therapy with nucleoside analogues. Virologic response at 12 months was not significantly different between the TDF monotherapy group and TDF-nucleoside analogue combination therapy group (p=0.098). The serum HBV DNA level was reduced to -4.49+/-1.67 log10 IU/mL in the TDF monotherapy group and to -3.97+/-1.69 log10 IU/mL in the TDF-nucleoside analogue combination therapy group at 12 months (p=0.18). In multivariate analysis, female sex (p=0.032), low baseline HBV-DNA level (p=0.013), and TDF monotherapy (p=0.046) were predictive factors for virologic response at 12 months. CONCLUSIONS: TDF monotherapy showed similar efficacy to that of TDF-nucleoside analogue combination therapy in patients with drug-resistant chronic hepatitis B.
Adult
;
Aged
;
Antiviral Agents/pharmacology/*therapeutic use
;
Cohort Studies
;
DNA, Viral/blood
;
Drug Resistance, Viral
;
Drug Therapy, Combination
;
Female
;
Hepatitis B virus/drug effects/genetics/isolation & purification
;
Hepatitis B, Chronic/*drug therapy/virology
;
Humans
;
Logistic Models
;
Male
;
Middle Aged
;
Multivariate Analysis
;
Nucleosides/chemistry/therapeutic use
;
Retrospective Studies
;
Sex Factors
;
Tenofovir/*therapeutic use
;
Treatment Outcome
;
Young Adult
10.The impact of pegylated interferon and ribavirin combination treatment on lipid metabolism and insulin resistance in chronic hepatitis C patients.
Hee Jae JUNG ; Young Seok KIM ; Sang Gyune KIM ; Yun Nah LEE ; Soung Won JEONG ; Jae Young JANG ; Sae Hwan LEE ; Hong Soo KIM ; Boo Sung KIM
Clinical and Molecular Hepatology 2014;20(1):38-46
BACKGROUND/AIMS: Lipid profile and insulin resistance (IR) are associated with hepatitis C virus (HCV) and may predict the chronic hepatitis C (CHC) treatment response. The aim of this study was to determine the association between CHC treatment response and lipid profile and IR change during treatment. METHODS: In total, 203 CHC patients were reviewed retrospectively between January 2005 and December 2011 at Soon Chun Hyang University Hospital. The lipid profile, homeostasis model for assessment (HOMA) of IR (HOMA-IR), and HOMA of beta cells (HOMA-beta) were evaluated before interferon plus ribavirin therapy (BTx), at the end of treatment (DTx), and 24 weeks after the end of treatment (ATx). RESULTS: A sustained virologic response (SVR) was achieved by 81% of all patients (49/60), 60% (n=36) of whom possessed genotype 1, with the remainder being non-genotype-1 (40%, n=24). Apart from age, which was significantly higher in the non-SVR group (SVR, 48.0+/-11.2 years, mean+/-SD; non-SVR, 56.6+/-9.9 years; P<0.01), there were no significant differences in the baseline characteristics between the SVR and non-SVR groups. In the SVR group, low density lipoprotein-cholesterol (LDL-C) had significantly changed at DTx and ATx compared to BTx. In addition, HOMA-IR and HOMA-beta were significantly changed at DTx in the SVR group. Among those with a high baseline insulin resistance (HOMA-IR >2.5), HOMA-IR was significantly changed at DTx in the SVR group. CONCLUSIONS: LDL-C appears to be associated with HCV treatment in SVR patients. Furthermore, eradication of HCV may improve whole-body IR and insulin hypersecretion, as well as high baseline insulin resistance (HOMA-IR >2.5).
Adult
;
Aged
;
Antiviral Agents/pharmacology/*therapeutic use
;
Cholesterol/blood
;
Drug Therapy, Combination
;
Female
;
Genotype
;
Hepacivirus/genetics
;
Hepatitis C, Chronic/*drug therapy
;
Humans
;
*Insulin Resistance
;
Interferon-alpha/pharmacology/*therapeutic use
;
Lipid Metabolism/drug effects
;
Male
;
Middle Aged
;
Polyethylene Glycols/pharmacology/*therapeutic use
;
Recombinant Proteins/pharmacology/therapeutic use
;
Ribavirin/*therapeutic use
;
Treatment Outcome
;
Triglycerides/blood

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