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Snapshot
  • A 50-year-old man with a history of HIV presents to his infectious disease clinic for a rash. He reports that he stopped taking his anti-retroviral medication about 2 months ago due to gastrointestinal upset with each dose. He reports feeling well overall but reports developing a painless rash on his legs. Yesterday, he had night sweats and a low-grade fever.  On physical exam, there are scattered violaceous papules and plaques on his bilateral lower extremities. Laboratory studies reveal a CD4+ count of < 200/uL. A skin biopsy is taken, and the patient is restarted on antiretrovirals and started on interferon therapy. (Kaposi sarcoma)
Overview
  • Drugs
    • interferon-α
    • interferon-β
    • interferon-γ
  • Mechanism of action
    • interferons are part of the innate host defense against viruses
      • they are glycoproteins that are naturally made by virus-infected cells to fight the infection
      • interferon upregulates MHC expression
    • interferon-α and interferon-β
      • downregulates protein synthesis to prevent viral replication
    • interferon-γ
      • secreted by NK cells and T cells, activating macrophages
      • activates NK cells to also eliminate virus-infected cells
  • Clinical use
    • viral infections, tumors, malignancies, and other conditions
    • interferon-α
      • hepatitis B
      • hepatitis C
      • Kaposi sarcoma
      • condyloma acuminatum
      • hairy cell leukemia
      • renal cell carcinoma
      • malignant melanoma
      • follicular lymphoma
    • interferon-β
      • multiple sclerosis
    • interferon-γ
      • chronic granulomatous disease
      • osteopetrosis
  • Adverse effects
    • flu-like symptoms
    • neutropenia
    • depression
    • myopathy
    • focal segmental glomerulosclerosis (nephrotic syndrome)
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Questions (1)

(M1.MC.14.67) A 16-year-old Mexican female presents with symptoms of the common cold after the patient's respiratory epithelial cells were infected with Rhinovirus. Due to the presence of the virus, her respiratory epithelial cells begin producing interferon. Which is of the following is LEAST likely to be an outcome of the activation of the interferon response? Tested Concept

QID: 101526
1

Decreased viral replication within the cell

6%

(3/54)

2

A rhinovirus-specific, cell-mediated immune response

33%

(18/54)

3

Upregulation of NK cell ligands on the infected cell

15%

(8/54)

4

Activation of NK cells

7%

(4/54)

5

Interferon binding to nearby uninfected epithelial cells

35%

(19/54)

M 1 D

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